Mobicred

Personal Details

First Name

Surname

ID Number

Contact Number

Nationality

Country of Activity

Address Details

Residential Address(Street/Building & Number)

Residential Address(Optional)

Suburb

City

Postal Code

Account Creation

Email Address

Confirm Email Address

Create Password

Confirm Password

Please enter a password that meets the following criteria.

Minimum length: 8

At least 1 of the following characters: a - z
At least 2 of the following characters: 0 - 9
At least 1 of the following characters: A - Z
These special characters are not allowed: &|=[]%+^\'

Monthly Income

Monthly Income Before Deductions

Monthly Take Home Income

Other Income

Why do we need to know this information?
As a registered credit provider in South Africa it is our responsibility to ensure that you are able to afford the credit you are applying for.

Therefore these questions will allow us to pre-score you to ensure you qualify for finance.

All information submitted will be treated in the strictest confidence and will not be shared with any 3rd parties or other financial institutions.

Monthly Expenses

Expenses - Accommodation

Expenses - Transport

Expenses - Medical

Expenses - Food

Expenses - Water/Electricity

Expenses - Education

Expenses - Child Maintenance

Employment Information

Employment Category

Employer's Name

Employer Work Number

Contract Expiry Date

Give Us A Reference

Name

Surname

Mobile Number

Payment Information

Bank Account Number

Branch Number

Name of Bank

Branch Name

Mobicred will run a Debicheck collection monthly, do you authorise Mobicred to request the mandate from your bank?

Customer Protection Insurance (CPI)

For your protection your credit facility includes Customer Protection Insurance (CPI) underwritten by Guardrisk Life Limited, a licensed life insurer and authorized financial services provider (FSP76). CPI is administered by RCS Cards (Pty) Limited, an authorized financial services provider (FSP44481). You are not obligated to accept this CPI policy, but you will then be required to cede an alternate policy to RCS, which must have at least the same benefits as the RCS CPI.

Should you wish to substitute the RCS CPI with a policy of your own choice that has the same benefits, you can either pause this credit facility application until such time as the cession has been registered by your substitution Insurer, or you take out the RCS CPI policy in the interim, and provide the RCS insurance team with the relevant documents in order to start the substitution process afterwards, which can take up to a few weeks to finalize. Should the cession of your substitution policy be successful, the RCS CPI policy will be cancelled but no refund of premiums will be due as you would have enjoyed cover in this period.

Guardrisk and RCS Cards (Pty) Ltd have concluded a shareholder and subscription agreement that entitles RCS Cards (Pty) Ltd to place insurance business with Guardrisk. The shareholder and subscription agreement entitles RCS Cards (Pty) Ltd to share in the profits and losses generated by the insurance business. Guardrisk may distribute dividends, at the sole discretion of its Board of Directors, to RCS Cards (Pty) Ltd during the existence of the Policy.

CPI will provide the following cover:

Death – covers your outstanding account balance
Permanent Disability - covers your outstanding account balance
Loss of Income – covers up to 12 months’ account instalments
Temporary Disability - covers up to 12 months’ account instalments

Premiums are calculated at R4,50 per R1,000 of your outstanding balance
Click HERE to view the CPI policy terms and conditions and exclusions

Your insurance premiums will be billed to your account and collected as part of your instalment.
You will only have insurance cover if your account is not in arrears.

I understand that all pre-existing conditions are excluded for the first 12 months of cover and that loss of income cover is only applicable after a 3-month waiting period.

I understand that I have the right to waive the proposed RCS CPI and to substitute it with a policy of my own choice which covers the same benefits as the RCS CPI and which then must be ceded to RCS with certain written documentation as stipulated in the National Credit Act 34 of 2005.

Additional Information

Are you under debt review, sequestration, or administration, or do you plan to apply for debt review?

Mobicred will trigger a Debicheck mandate request to your bank to authorise Mobicred to collect the monthly payment from your bank account per the agreement and mandate. This mandate must be authorised by you via your bank process before the payment will be issued. Please tick the box to confirm.

Please tick this box to confirm that the details entered above are true and correct, and that you authorise to verify your information with a credit bureau or other third party or conduct any enquires about you.

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