Application

PLEASE COMPLETE THIS APPLICATION FORM

BOND DETAILS

EMPLOYER DETAILS

SALARY DETAILS

BANK DETAILS

I hereby agree that the information above is true and correct *

DRIVING DETAILS

LANGUAGE PREFERENCE

HOUSEHOLD INCOME DETAILS

HOUSEHOLD & EXPENSES PER MONTH

I CONFIRM THAT: *
I CONFIRM THAT: *

DECLARATION BY CLIENT

I hereby grant the Owner or Agent of EZ Wheels the right to communicate with me through any electronic / written media or verbally to make available to me, their product offering and to utilize my information for supporting products as communicated by one of the Credit Provider’s Partner. *
I hereby grant the Owner or Agent of EZ Wheels the right to increase my credit limit once every year to accommodate any value-added product needed and requested by me. *
I hereby declare that all information provided above is true and correct *

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