Bond Gallery Application

Application Form

Please complete the form below. Your application will be linked to Daleen Botha.

Home Loan Specialist

Assigned consultant

Daleen Botha

Home Loan Specialist

daleenb@bondgallery.co.za 084 810 5976 Office: 011 954 3316

View business card

Bond Application - Single Consent Blocks

Application Setup
Personal Details
Contact Details
Employment Details
Credit History
Declarations
Data Privacy

Application Setup

Application type

New Loan

Further Loan

Pre-qualification

Does this application include a co-applicant or surety?

Yes

Applicant / income category

Employed - Fixed Salary

Employed - Commission Earned

Company / Legal Entity

Company / Legal Entity Details

Complete this section only for company or legal entity applications.

Registered company / legal entity name

Trading name

Entity type

Company / registration number

Company income tax number

VAT registration number, if applicable

Directors / members / trustees / beneficial owners

Authorised representative name

Authorised representative capacity

Section A: Personal Details - Primary Applicant

Title

Gender

Male

Female

First Name/s

Surname

Date of birth

ID Type

ID / Passport number

Document expiry date

If passport, country of issue

Refugee ID card number

SA Citizen

Yes

Nationality

City of birth

Country of birth

SA Permanent resident

Yes

Are you a temporary resident of SA?

Yes

Permit type

Permit number

Permit Expiry Date

Marital status

If married ANC, register in both names

Yes

If married, country of marriage

No. of dependants

Ethnic Group

SA Income tax number

If tax number unavailable

Do you file any tax returns outside of SA?

Yes

If so, country and tax number

Current residential status

Are you a first time home buyer?

Yes

Will this property be your main residence?

Yes

Highest level of education

Do you currently smoke, or have you smoked in the last 12 months any form of tobacco or e-cigarettes?

Yes

Are you a public official in a position of authority?

Yes

Are you related to or associated with a public official in a position of authority?

Yes

What is the nature of the relationship or association?

Name and surname of public official in a position of authority that you are related or associated with

Section A: Personal Details - Co-applicant / Surety

Secondary applicant role

Title

Gender

Male

Female

First Name/s

Surname

Date of birth

ID Type

ID / Passport number

Document expiry date

If passport, country of issue

Refugee ID card number

SA Citizen

Yes

Nationality

City of birth

Country of birth

SA Permanent resident

Yes

Are you a temporary resident of SA?

Yes

Permit type

Permit number

Permit Expiry Date

Marital status

If married ANC, register in both names

Yes

If married, country of marriage

No. of dependants

Ethnic Group

SA Income tax number

If tax number unavailable

Do you file any tax returns outside of SA?

Yes

If so, country and tax number

Current residential status

Are you a first time home buyer?

Yes

Will this property be your main residence?

Yes

Highest level of education

Do you currently smoke, or have you smoked in the last 12 months any form of tobacco or e-cigarettes?

Yes

Are you a public official in a position of authority?

Yes

Are you related to or associated with a public official in a position of authority?

Yes

What is the nature of the relationship or association?

Name and surname of public official in a position of authority that you are related or associated with

Section B: Contact Details - Primary Applicant

Home number

Cellphone number

Work number

E-mail address

Fax number

Home language

Language for correspondence

Residential Address - Primary Applicant

Street

Suburb

City

Postal code

Country

Length at current address - Years

Length at current address - Months

Postal Address - Primary Applicant

Same as residential address?

Yes

Street / PO Box

Suburb

City

Postal code

Country

Contact and address details for future legal correspondence are different to postal address?

Yes

Legal correspondence - Street / PO Box

Legal correspondence - Suburb

Legal correspondence - City

Legal correspondence - Postal code

Legal correspondence - Country

Section B: Contact Details - Co-applicant / Surety

Home number

Cellphone number

Work number

E-mail address

Fax number

Home language

Language for correspondence

Residential Address - Co-applicant / Surety

Street

Suburb

City

Postal code

Country

Length at current address - Years

Length at current address - Months

Postal Address - Co-applicant / Surety

Same as residential address?

Yes

Street / PO Box

Suburb

City

Postal code

Country

Section C: Employment Details - Primary Applicant

Occupation Status

Occupational Level

Employment Details - Primary Applicant

Employed only

Nature of occupation

Employer Name

Employer Contact Number

Company registration no

Employee number

Employment Period - Years

Employment Period - Months

Employer street

Employer suburb

Employer city

Employer country

Employer postal code

Percentage of income derived from own business, if any

Are you a shareholder of your employer’s business?

Yes

Percentage shareholding

Do you work in South Africa?

Yes

Does this purchase coincide with a job change?

Yes

Were you previously employed?

Yes

Previous Employment Details - Primary Applicant

Two most recent

Previous employer 1

Previous employer 1 duration - Years

Previous employer 1 duration - Months

Previous employer 2

Previous employer 2 duration - Years

Previous employer 2 duration - Months

Section C: Employment Details - Co-applicant / Surety

Occupation Status

Occupational Level

Employment Details - Co-applicant / Surety

Employed only

Nature of occupation

Employer Name

Employer Contact Number

Company registration no

Employee number

Employment Period - Years

Employment Period - Months

Employer street

Employer suburb

Employer city

Employer country

Employer postal code

Percentage of income derived from own business, if any

Are you a shareholder of your employer’s business?

Yes

Percentage shareholding

Do you work in South Africa?

Yes

Does this purchase coincide with a job change?

Yes

Were you previously employed?

Yes

Previous Employment Details - Co-applicant / Surety

Two most recent

Previous employer 1

Previous employer 1 duration - Years

Previous employer 1 duration - Months

Previous employer 2

Previous employer 2 duration - Years

Previous employer 2 duration - Months

Section D: Credit History - Primary Applicant

Are you currently under Administration?

Yes

Were you ever under Administration?

Yes

Has a judgement ever been taken against you?

Yes

Are you currently under debt review?

Yes

Debt counsellor name

Debt counsellor phone number

Are you currently under any debt re-arrangement?

Yes

Have you ever been declared insolvent?

Yes

Date of insolvency

If rehabilitated, date

Are you aware of any adverse credit listings?

Yes

If yes, specify

Are you currently in a credit bureau dispute?

Yes

Existing Suretyships - Primary Applicant

Are you bound by any surety agreements?

Yes

If yes, specify amount

Are you currently paying this account?

Yes

Monthly Instalment

Details of suretyship

Will you be settling this account/debt?

Yes

New Instalment

Surety in favour of

Section D: Credit History - Co-applicant / Surety

Are you currently under Administration?

Yes

Were you ever under Administration?

Yes

Has a judgement ever been taken against you?

Yes

Are you currently under debt review?

Yes

Debt counsellor name

Debt counsellor phone number

Are you currently under any debt re-arrangement?

Yes

Have you ever been declared insolvent?

Yes

Date of insolvency

If rehabilitated, date

Are you aware of any adverse credit listings?

Yes

If yes, specify

Are you currently in a credit bureau dispute?

Yes

Existing Suretyships - Co-applicant / Surety

Are you bound by any surety agreements?

Yes

If yes, specify amount

Are you currently paying this account?

Yes

Monthly Instalment

Details of suretyship

Will you be settling this account/debt?

Yes

New Instalment

Surety in favour of

Supporting Documents

Upload the documents required for the selected applicant / income category. Accepted file types: PDF, JPG, JPEG and PNG.

Do you own other properties?

Yes

Employed Client Requirements - Fixed Salary

Shown when Applicant / income category is Employed - Fixed Salary.

Proof of income / latest 3 salary slips

Choose File

Latest 3 months bank statements - non-internet, stamped

Choose File

S.A. ID document - if card, upload front and back

Choose File

Income tax number

Copies of lease agreements, if you own other properties

Choose File

Employed Client Requirements - Commission Earned

Shown when Applicant / income category is Employed - Commission Earned.

Proof of income / latest 6 salary slips

Choose File

Latest 6 months bank statements - non-internet, stamped

Choose File

S.A. ID document - if card, upload front and back

Choose File

Income tax number

Copies of lease agreements, if you own other properties

Choose File

Company / Legal Entity Document Requirements

Shown when Applicant / income category is Company / Legal Entity.

Copy of S.A. ID document

Choose File

Confirmation of drawings by Accountant / Auditor

Choose File

Signed audited business financials for the past 2 years

Choose File

Share Certificate

Choose File

Solvency Certificate

Choose File

6 months business bank statements - non-internet, stamped

Choose File

6 months personal bank statements - non-internet, stamped

Choose File

Latest 2 years IT34s

Choose File

Management accounts not older than 3 months

Choose File

Signed assets, liabilities and balance sheet

Choose File

CK1 and CK2 company documents

Choose File

Additional supporting documents

Choose File

Document notes

Section I: Declarations and Consents

If you are currently working with an Agent, please add the Agent Name and Agency Name:

Some description about this section

First Name

Last Name

Agency Name

Bond Gallery Declarations and Consents

I/ We, the undersigned do hereby appoint ("my Representative at - Bond Gallery")

Consent to Bond Gallery facilitating an application for home loan finance on my/our behalf.
Bond Gallery is a home loan originator and will be facilitating the home loan application on the applicant’s behalf. The applicant has authorised Bond Gallery to proceed with such application.
Acknowledge that personal, financial and other information is furnished to Bond Gallery for the purposes of a pre-qualification and/or application for home loan finance and are aware that I/we are required to furnish all such information truthfully and fully.
Consent to Bond Gallery receiving all communication from the bank/s, including the quotation, pertaining to my/our home loan application. I/We consent to Bond Gallery issuing the estate agent with a copy of the quotation and pre-qualification results.
Consent to Bond Gallery and banks making enquiries to credit bureaux when assessing my/our pre-qualification and home loan application for finance.
Confirm that I/we hold no other citizenships and residence for local and international tax purposes, other than those disclosed in this application form, and will inform the lender in writing of any change of this status within 30 days of the change of status.
Consent to Standard Bank, ABSA and Nedbank electronically retrieving my/our bank statements.
Appoint Bond Gallery as my/our lawful representative and agent to obtain a copy of my/our personal credit report/s (“PCR”) from credit bureaux. I/We consent to the credit bureau releasing a copy of my/our PCR to Bond Gallery and for Bond Gallery to have sight of the content of my/our PCR solely for the purpose of providing me/us with advice or assistance with managing my/our credit.
I/We irrevocably consent that Nedbank and First National Bank may request my/our salary advices from my/our employer(s) or any third party.
I/We consent that the bank may obtain and use my/our information from third-party qualification data providers to conduct an assessment to determine my/our eligibility for, and the appropriateness of, the home loan.
Give consent to the bank to process my/our personal information to do fraud checks, as well as checks and reporting to the South African Fraud Prevention Services.
Consent, after my/our mortgage bond is registered, to receiving estate planning advice of a free Will and to explore any changed insurance requirements. I/We are aware that I/we can opt out at any time.
Consent to the bank and its affiliates to use my/our information provided herein to apply for other banking products on my/our behalf after my/our acceptance of the bank’s offer of finance.
Consent to Bond Gallery making application to the NHFC on my/our behalf for First Home Finance and for Bond Gallery to receive all communication from the NHFC pertaining to my/our First Home Finance application, including the final outcome of my/our application. I/We understand the purposes for which my/our personal information is required and for which it will be used by Bond Gallery and the NHFC.

Agree to the above

Yes, I/we agree to the above

Section J: Data Privacy

Your data privacy is important to us.

While we will not share your personal information with anyone, we do not want you to miss out on the latest information and our products and services that would interest you. Remember, you can opt out at any time.

I/we confirm that the notifications above have been read and understood.

Agree to the above

Yes, I/we agree to the above

Primary Applicant: Data privacy marketing consent

Yes please, I’d like to be kept up to date on your offers and services

No thanks, I don’t want to hear about your offers and services

Co-applicant / Surety: Data privacy marketing consent

Yes please, I’d like to be kept up to date on your offers and services

No thanks, I don’t want to hear about your offers and services

Primary applicant signature

Sign Here

Primary applicant date

Co-applicant / Surety signature

Sign Here

Co-applicant / Surety date