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Please note: Please take the time to fill in your correct details on the application form below. Once you have submitted your application, you will receive detailed correspondence from us within 30 minutes with regards to your application.

Please complete the form below.

* Denotes required field

ID NUMBER:*
TITLE:
FIRST NAME : *
LAST NAME : *

CELL NUMBER: *

WORK NUMBER:
FAX NUMBER:
E-MAIL ADDRESS:*
CONFIRM E-MAIL ADDRESS: *
ARE YOU BLACKLISTED? :
LOAN AMOUNT : *
PURPOSE OF LOAN: *
OCCUPATION:
SALARY DATE:*
SALARY FREQUENCY : *
GROSS INCOME : *
BANK NAME : *
ACCOUNT TYPE :
ACCOUNT NUMBER : *
BRANCH CODE : *
You are required to “Tick” the Box below as consent, then click “submit application”
By ticking this box and submitting this application, you (the applicant/client) confirm that you (the applicant/client) have read the Terms of Service, Terms of Use, Legal Disclaimer and the Privacy Policy (Collectively known as the Policies) of Loan Tracer SA and fully understand the contents thereof and are satisfied therewith. If you do not agree to the Policies, do not submit this application.

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