Medical Cosmetics Loan Application

Medical Cosmetics Loan Application

Personal Application for Cosmetic Surgery Loan

Personal Information

First names(Required)

(as per your ID)

Surname(Required)

(as per your ID)

Mobile Phone Number(Required)

(as registered with your bank account)

ID Number(Required)

(South African)

Physical Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email(Required)

Marital Status(Required)

Please select one

Marital Consent

IF YOU ARE MARRIED IN COMMUNITY OF PROPERTY OR BY CUSTOMARY LAW, IT IS A LEGAL REQUIREMENT IN TERMS OF THE MATRIMONIAL PROPERTY ACT, TO OBTAIN

YES

Let's talk about your Cosmetic Surgery Procedure

What type of Procedure do you need a loan for?(Required)

Insert a description of the procedure here

How much do you want to loan for the procedure?(Required)

Always a good idea to get a quote first. REMEMBER, WE PAY THE CLINIC or DOCTOR DIRECTLY.

Payback Period(Required)

6 Months

12 months

24 months

Have a look at our online repayment calculator to see what payback amount suits your budget.

Select your choice of Clinic or Doctor(Required)

If the Clinic or Doctor is not listed here, choose OTHER

Name of Clinic or Doctor(Required)

If you chose OTHER, please type the name of the Clinic or Doctor here

Contact number(Required)

We need to contact the Clinic or Doctor to onboard them as an InkFin Partner

Financial Information

Employment Status

Employed Full-Time

Employed Part-Time

Self-Employed

Not Employed

Homemaker

Retired

Student

Monthly Income(Required)

Best Day of the Month for Debit Order

Please enter a number from 1 to 31.

eg: 25th or 31st

Your Employer's name(Required)

Your Employers Contact Number(Required)

Where we can confirm your employment

Please attach pic or copy of your ID

We need a clear copy please

Max. file size: 32 MB.

Please attach 3 Months Payslips

You can also email them to applications@inkfin.co.za after submitting this form.

Drop files here or

Max. file size: 32 MB, Max. files: 3.

Please attach 3 Months Bank Statements

You can also email them to applications@inkfin.co.za after submitting this form.

Drop files here or

Max. file size: 32 MB, Max. files: 3.

Proof of Address- FICA

(Not older than 3 months). You can also email it to applications@inkfin.co.za after submitting this form.

Max. file size: 32 MB.

Credit Check Consent(Required)

I hereby consent and authorise that Inkfin (Pty) Ltd contact, request and obtain information from a registered credit bureau, to perform an assessment of my behaviour, profile, payment patterns, indebtedness and creditworthiness, and make any reasonable enquiries to verify and research any details provided by me to Inkfin (Pty) Ltd.

Where did you first hear about InkFin?

The Internet

Social Media

From the Clinic or Doctor

Through a friend

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Name

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