Loan Application Form

Please complete all fields accurately. This information is required to comply with the National Credit Act (No. 34 of 2005) for affordability assessment, employment confirmation, and credit checks.

Personal Details

Name:Enter your full name.

Surname:Enter your family name.

South African ID Number:Must be 13 digits (e.g., 1234567890123).

Contact Number:Enter a valid phone number (e.g., 0821234567).

Upload ID Copy (PDF or Image):Upload a clear copy of your ID.

Email Address:Enter a valid email (e.g., example@domain.com).

Residential Address: Street Number, Street Name, Suburb and Area CodeInclude street, city, and postal code.

Financial Information (For affordability check)

Gross Monthly Income:Enter your total monthly earnings.

Total Monthly Expenses:Include all monthly costs.

Existing Monthly Debt Repayments:Include existing loan repayments.

Salary Date:Select the day of the month.
Select Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Upload Three Month Bank Statements (PDF)(minimum 1, maximum 3):

Employment Details

Employer Name:Enter your current employer.

Employer Contact Number:Enter a valid employer phone number.

Place of Employment:Enter the name of your workplace.

Job Title:Enter your current job title.

Employment Type:Select your employment sector.
Select Employment Type Education Health Retail Finance
Upload Latest Payslip (PDF):Upload a single PDF file.

I consent to Care Credit sharing my employment information with a third party for the purpose of conducting a credit check. I understand that this is a mandatory requirement for processing my loan application, and failure to provide consent will prevent the application from proceeding. [Mandatory]

Loan Details

Requested Loan Amount:Select your desired loan amount.
R1000 R1500 R2000 R2500 R300 R400 R500 R100 R150 R200 R250

Declarations and Consent

I declare that all information provided in this application is true, accurate, and complete. *
I consent to the credit provider conducting a credit check through a registered credit bureau and sharing my information with credit bureaus as required by the National Credit Act. *
I consent to the credit provider contacting my employer to verify my employment details. *
I have read and agree to the Terms and Conditions available at https://carecredit.co.za/terms.html. *
I acknowledge I can contact admin@carecredit.co.za or 0861 123 456 for support or complaints, with resolutions provided within 5 business days. I acknowledge my personal information will be processed per the Protection of Personal Information Act, retained for 5 years, and I can request access, correction, or deletion by contacting admin@carecredit.co.za. Submit Application