Credit check & Affordability

1

Personal Information

Full Name & Surname

Identity Number

Mobile Number

Email Address

Physical Address

2

Financial Information

Please provide your current financial details for home loan pre-qualification assessment.

Gross Monthly Salary (R)

R

Nett Monthly Salary (R)

R

Monthly Expenses (R)

R

Disposable Income: R 0.00

3

Consent & Authorization

CONSENT IN TERMS OF THE PROTECTION OF PERSONAL INFORMATION ACT

[Business Partner] and BetterLife Origination Services Proprietary Limited (‘MortgageMax’) (a subsidiary of BetterLife Group Limited) cares about your privacy and information security.

I agree to provide personal information and make use of home loan pre-qualification service and/or credit check through a registered credit bureau.

I consent to credit checks, fraud checks, and reporting to the South African Fraud Prevention Service.

I appoint MortgageMax as my lawful representative to obtain my personal credit report (PCR) from Experian.

I explicitly consent to MortgageMax sharing my PCR with third parties (financial institutions, estate agents, property developers, conveyancing attorneys).

Third Party Definition: Financial institution and/or its representatives, the estate agent, the property developer, the conveyancing attorney and/or any third party including but not limited to the lead provider dealing with a property that I am interested in purchasing.

4

Digital Signature & Submission

IP Address: Detecting…

Date & Time:

Digital Signature

Sign above using your mouse or touch screen