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Mandatory fields are marked with *

Company Details

Company Name *

Company Registration Number *

VAT Registration Number

How long have you been in business? *

Company Contact Info (Email Address & Contact Number) *

Main Business Industry *

Registered Address

Director (Full Name)

Director ID Number

Director Phone Number *

Transaction Details

Are all SARS obligations up to date? *

(VAT. PAYE and IncomeTax)

Average Monthly Turnover (R) *

Monthly Estimated Amount Required (R) *

Total outstanding debtor value (R) *

Payment Terms from Debtors

(Days)

List your 2 largest debtors (and average sales p/m)

Are the debtors ceded to any institution? (Yes/No) *

(If YES, to whom?)

Does the company have any insurance over debtors? (Yes/No)

(If YES, provide)

Documents

Kindly provide the following documents together with the completed application form:

The companys latest annual financial statements *

The newest management accounts (if possible)

The last 6 months bank statements *

Asset Register

Latest debtors age analysis

Latest creditors age analysis

The three largest unpaid invoices

Bank account confirmation letter *

CIPC Documents *

I approve credits searches on all directors and accept DiscountDesk's Privacy Policy. *

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