Application

PLEASE COMPLETE THIS APPLICATION FORM

EMPLOYER DETAILS

BANK DETAILS

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

DRIVING DETAILS

LANGUAGE PREFERENCE

BOND DETAILS

HOUSEHOLD / INCOME DETAILS PER MONTH

SELECT:

HOUSEHOLD & EXPENSES PER MONTH

EXCLUSIVE OFFERS TO EZ-WHEELS APPLICANTS

 

HEALTH

Would you like a FREE Quote for Affordable Health Insurance with Oneplan from R420pm, giving you access to Private Hospital Cover and upfront cash for Doctors Visits?

PET

Do you have Pets? Get an obligation FREE Quote from Oneplan Pet Insurance, affordable plans to choose from R70pm

Thank you for submitting your details. One of Oneplan’s friendly agents will be in touch to give you an obligation FREE Insurance quote. Oneplan is an authorised FSP. Underwritten by Bryte Insurance Company Limited.

DECLARATION BY CLIENT

I hereby grant the Owner or Agent of EZ Lend 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 *