Risima Housing Finance Corporation (Soc) Ltd Head Office

Company Registration no: 1966/001312/30 PO Box 760

NCR Registration No: NCRCP1885 Lebowakgomo
Tel: +27 (15) 633-4700
Fax: +27 (15) 633-6876

HOME LOAN APPLICATION

• APPLICANT’S DETAILS Client Ref No:

Title: Adv Dr. Miss Mr. Mrs. Ms Prof Pas

First Names:
Surname:
Date of Birth Gender: M F
(ddmmyyyy)
ID/Passport number:
South African Citizen Yes No If no, Specify nationality:
Permit number Country of issue:
Permit expiry date
Type of permit Work Study Perm residence Asylum seeker Refugee
Work Contract Issue date Expiry date
(ddmmyyyy)
SA Resident Yes No Type of residency : Temporary Permanent
Race African Asian Colored White
Preferred language English Afrikaans Other:
Marital status Married Single Divorced Widowed
If married, how? ANC(with/without accrual) COP Customary
Declared insolvent Yes No If yes, date:
Been rehabilitated Yes No If yes, date:
Physical address
(street)
Suburb Postal Code
Town/City
Postal Address
Suburb Postal Code
Town/City
Telephone number (H) ( )
Telephone number (W) ( )
Fax number ( )
Mobile ( )
E-mail address:
Status: Normal

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 • CO-APPLICANT’S DETAILS (If any) Client Ref No:

Title: Adv Dr. Miss Mr. Mrs. Ms Prof Pas

First Names:
Surname:
Date of Birth Gender: M F
(ddmmyyyy)
ID/Passport number:
Yes No If no, Specify nationality:
South African Citizen
Permit number Country of issue:
Permit expiry date
Work Study Perm residence Asylum seeker Refugee
Type of permit
Work Contract
(ddmmyyyy) Issue date Expiry date
Yes No Type of residency : Temporary Permanent
SA Resident
African Asian Colored White
Race
English Afrikaans Other:
Preferred language
Married Single Divorced Widowed
Marital status If married, how? ANC(with/without accrual) COP Customary
Yes No If yes, date:
Declared insolvent
Yes No If yes, date:
Been rehabilitated
Physical address
(street)
Suburb Postal Code
Town/City
Postal Address
Suburb Postal Code
Town/City
Telephone number (H) ( )
Telephone number (W) ( )
Fax number ( )
Mobile ( )
E-mail address:
Status: Normal

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COMPANY / CLOSE CORPORATION/TRUST/ASSOCIATION DETAILS

Registered name

Director(s)/Member(s)/Trustee(s)/Partner(s)

Physical address
Postal code
Telephone number Fax number
Registration number
Vat registration number
Landlord name:
Contact number:

• YOUR BANKING ACCOUNT

DETAILS

Applicant Co-applicant

Bank Name:
Branch Name:
Branch code:
Account number:
Account Holder:
Account type:

• APPLICANT’S EMPLOYMENT DETAILS

Employment Status: Employed Self Employed Other

Employer: Length of Service:
Empl. address / code
Occupation:
Superior name:
Employment date:
Work Station :
Monthly salary:
Net salary:
Pay date :
Pay date :
Retirement age:
Pay point:
Salary number:
Previous Employment Ignore Length of Service:
PF membership no: Ignore

• CO- APPLICANT’S EMPLOYMENT DETAILS (If any)

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Employment Status: Employed Self Employed Other
Employer: Length of Service:
Empl. address / code
Occupation:
Superior name:
Employment date:
Work Station :
Monthly salary:
Net salary:
Pay date :
Retirement age:
Pay point:
Salary number:
Previous Employment Length of Service:
PF membership no:

• REFERENCES/RELATIONS (1)
Applicant Co-applicant
Adv Dr. Miss Mr. Adv Dr. Miss Mr.
Title:
Mrs. Ms Prof Pas Mrs. Ms Prof Pas
First Names:
Surname:
Tel – office:
Mobile:
Relation type:

• REFERENCES/RELATIONS (2)
Applicant Co-applicant
Adv Dr. Miss Mr. Adv Dr. Miss Mr.
Title: Mrs. Ms Prof Pas Mrs. Ms Prof Pas
First Names:
Surname:
Tel – office:
Mobile:
Relation type:

Home Loan Application Page 4 of 11

 • APPLICANT’S DETAILS OF DEPENANTS

Full Names Gender Date of birth Relationship

• CO- APPLICANT’S DETAILS OF DEPENANTS (If any)

Full Names Gender Date of birth Relationship

• APPLICANT’S FINANCIAL COMMITMENTS

Monthly commitments To whom owing Amount owed Monthly payments

Personal loans
Bank overdraft
Credit agreements
Mortgage bonds
Other, Specify:
Motor Finance:

Home Loan Application Page 5 of 11

 • CO- APPLICANT’S FINANCIAL COMMITMENTS (If any)

Monthly commitments To whom owing Amount owed Monthly payments

Personal loans
Bank overdraft
Credit agreements
Mortgage bonds
Other, Specify:
Motor Finance:

• PROPERTY DETAILS

Type of investment Property No 1 Property No 2 Property No 3

Stand No
Township / Place
Area of land (sq m)
Date of purchase / Built
Balance now owing
Nature & cost of improvements since purchase
Nature of existing building to be renovated
Is property registered in your name?

Name & address of seller

Builder’s name & address

When may valuer inspect the property?

• INVESTMENTS

Type of investment Account No Name of financial institution Amount Maturity date

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 • MONTHLY INCOME & EXPENDITURE

Income Rand
Applicant’s net salary

Spouse/Co-applicant’s net salary

Other income (specify)

Total income

Expenses

Applicant’s expenses

Spouse/Co-applicant’s expenses (if any)

Total Expenses

Net disposable income per month

Declaration

1. I/We the undersigned …………………………………………………………………………………………………. certify that all the

information provided to the Lender is true, correct and that I/we have not withheld any information which would affect the
decision of the lender.
2. I/We acknowledge that providing the lender with incorrect or false information may result in me/us being denied the protection
offered by the National Credit Act, No 34 of 2005 if applicable.
3. I/We certify that I/We am/are not under debt review ,an administration order, sequestration, or declared over-indebted.
4. I/We consent to the lender sending confidential information to the fax number supplied herein.
5. I/We confirm that I am/We are aware that my/our freehold property/ies must have homeowner’s comprehensive insurance.
Risima Housing Finance has proposed or offered that I/we purchase credit insurance policy through New Era Life Insurance or
Glenrand MIB, however, I/we reserve the right to waive the proposed policy purchase in favour of insurance policy of my/our
own choice.
6. I/We consent to credit checks being conducted by Risima Housing Finance Corporation (Pty) Ltd, in order to obtain my credit
record from Trans-Union for the purpose of my Home Loan application. I further authorize Risima to enquire about my
repayment behavior from my existing credit providers and from any of my credit references.

Applicant’s signature:________________________Spouse/Co-applicant______________________ Date_____________

Debit Order authorization

1.The customer(s) hereby authorize the Lender to effect the necessary changes to the amount payable under the Customer(s)
debit order authorization, in order to take into account customer's monthly installments provided that any alteration in the monthly
installment will be notified in writing by the lender to the customer in accordance with Section 104 and 120 the Act

2. It is also the sole responsibility of the customer(s) to ensure that the necessary salary stop order or split billing is amended to take
into account any adjustments to the customer(s) monthly installments.

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Supporting documentation
* Compulsory supporting documents
1. Latest pay slip (individuals)/ Other sources of income
2. Certified Copy of Identity Document(s) or Passport(s) & Spouse.
3. Certified Copy of marriage certificate.
4. Affidavit for not being married
5. 3 months bank statement
6. Proof of residence/ Letter from Tribal Authority (Not later than three months)
7. Work Permit (foreign residents)
8. Temporary residence certificate (foreign residents)
9. Income tax certificate number from SARS.
10. Financial statements (self employed, company, CC, Trust, Association, Partnership).
11. Owner's latest statement of Assets and Liabilities (self employed)
12. Offer to purchase
13. Copy of approved building plan

Marketing options
I/We the undersigned…………………………………………………………………………………………confirm that Risima has
presented us with a marketing options statement and I was /we were there and then given an opportunity to select the options as
follows:

1) Any form of telemarketing campaign conducted by Risima or its representatives: Accept Decline

2) Inclusion in the marketing or customer list that may be sold or distributed by Risima other than as required by the Act:

Accept Decline

3) Inclusion into any mass distribution of E-mail or SMS messages: Accept Decline

I/We confirm that I/we have read, understood and agree to be bound by the terms and conditions relating to this Home
Loan Application.

__________________________________ __________________
APPLICANT’S SIGNATURE DATE

___________________________________ __________________
SPOUSE/CO-APPLICANT’S SIGNATURE (If any) DATE

Confidential report by interviewing officer on applicant and / or property:

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For office use only

• LOAN APPROPRIATION

Property Value: R
Description Total Loan Own Contribution Loan
amount
required
Cash Other

Property
Purchase price
Construction
costs
Redemption of
existing loan
Additional loan
Purchase of land
Re advance as
add loan
Initiation fee
Admin fee
Progress
Inspection fee
Transfer costs
Registration fee
Total

• LOAN REQUIRED

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 DETAILS Rand

Total Loan
Total costs
Less Own contribution
Loan amount required

• CREDIT ACCOUNT CREATED: ACCOUNT NO:

Interest rate % Rural / Urban

Account type selected Term:
Amount applied for
Loan granted Date:
Loan start date
First installment date

• ACCOUNT TAB

Industry sector Housing Loans

District 1 2 3 4 5 6

• DETAILS TAB

Monthly Installment Salary Cash Bank

Loan officer / agent R.X.MACHABI
Loans funder Risima Housing Finance Corporation (Pty( Ltd
Guarantor RISIMA
GL Company 17204-03

Recommendation for approval of a housing loan

• LOAN REPAYMENT

DETAILS Rand

Monthly installment
Credit life bond protection insurance
Property insurance
Monthly Service fee
Total monthly amount due
Less Subsidy
Payment from basic salary
Total

• CONCLUSION

DETAILS Rand

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A loan of …………………………………......................
can be redeemed over a period of ………………….
at a monthly installment of ……………………………
applying from basic salary…………………………….
of the applicant’s income plus subsidy of ………..
Total R

Loans Origination Officer:

Signed Date

Loan Origination & Inspection Manager:

Signed Date

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