Consumer Credit Check Application

1. Personal Details

ID / Passport Number*

First Name(s) (as on ID)*

Surname*

Cellphone Number*

2. Address Details

Full Residential Address

Postal Code

3. Financial Details

Gross Income (R)*

Net Income (R)*

4. Installment Details

Installment Amount (R)

Is the installment paid by two or more parties? (Joint payment)

5. Verification Checks Included

All consumer credit checks include the following as standard:

Credit Bureau Profile Check Included

Payment History Analysis Included

Adverse Listing Check Included

Affordability Assessment Included

Optional add-on checks:

ID Verification with Photo +R100

Employment Verification +R150

Bank Statement Analysis +R200

6. Consumer Credit Check Fee

Standard Consumer Credit Check

Credit bureau profile + Payment history + Adverse listings + Affordability assessment

R350

Add-on services are charged in addition to the standard fee. Turnaround: 24–48 hours.

Total Due

Standard Credit Check: R350

R350

7. 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

TM Nkosi 901205

Example breakdown: T.M. Nkosi (initials + surname) + 901205 (first 6 digits of ID number 901205...)

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.

8. Declaration & Consent

I, the undersigned, request Somor CredIntel (Pty) Ltd to conduct a consumer credit check and affordability assessment on the individual identified in this application. I understand that this verification will involve accessing credit bureau data, payment history records, and other relevant financial databases.

I confirm that the information provided in this application is true and correct and that I am the consumer concerned or an authorised representative acting on their behalf. I consent to the processing of my personal information 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 consumer's credit profile, payment history, adverse listings, and affordability assessment results.

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

Applicant Full Name

Date

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

Consumer Credit Check Application

Payment Method

Reference Format

Application Submitted!