Business Credit Check Application

1. Business Details

Registration Number*

Business Name*

Business Address*

Postal Code*

Business Email Address

2. Representative Details

Provide the details of the person applying on behalf of the business.

First Name(s)*

Surname*

Cellphone Number*

Email Address*

ID Number

Position / Title

3. Financial Details

Provide the business financial information for the affordability assessment.

Gross Income (R)*

Net Income (R)*

Installment Amount (R)

Industry / Sector

4. Verification Checks Included

All business credit checks include the following as standard:

Business Credit Profile Check Included

Company Registration Verification Included

Director(s) Information Check Included

Financial Risk Assessment Included

Optional add-on checks:

Director ID Verification +R100

Director Credit Profile Check +R350

VAT Registration Verification +R150

Business Bank Statement Analysis +R200

5. Business Credit Check Fee

Standard Business Credit Check

Business credit profile + Company registration + Director info + Financial risk assessment

R650

Add-on services are charged in addition to the standard fee. Turnaround: 48 hours.

Total Due

Standard Business Credit Check: R650

R650

6. Payment & Reference

Payment Method

Electronic payments only. We accept EFT (Electronic Funds Transfer) and other electronic payment methods only. No cash or card payments are accepted.

Banking details will be provided on your invoice once you submit this application.

Reference Format

Use the following format as your payment reference and form reference:

Format

Initials + Surname + First 6 Digits of ID/Passport

Example

SC Intel 202628

Example breakdown: S.C. Intel (initials + surname) + 202628 (first 6 digits of ID number 202628...)

Printed Forms: Should this form be printed and completed by hand, please email the scanned/photographed form to info@somorcredintel.co.za with your reference number as the email subject line.

7. Declaration & Consent

I, the undersigned, request Somor CredIntel (Pty) Ltd to conduct a comprehensive business credit check and affordability assessment on the business named in Section 1. I understand that this verification will involve accessing publicly available business registration records, credit bureau data, director information from the Companies and Intellectual Property Commission (CIPC) and other relevant databases.

I confirm that the information provided in this application is true and correct and that I am authorised to act on behalf of the business. I consent to the processing of my personal information and the business information provided in accordance with the Protection of Personal Information Act (POPIA), 2013.

I understand that the credit check report will be shared with me and may include details about the business credit profile, company registration status, director information, financial risk indicators, and any discrepancies found between the business's claims and official records.

I have read and agree to the POPIA consent and declaration above*

Representative Full Name

Date

Office Use Only: Received by: ___________________________ Date: _________________ Add-ons Selected: _________________ Payment: [ ] EFT Reference: _________________________

Business Credit Check Application

Payment Method

Reference Format

Application Submitted!