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PERSONAL DETAILS

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Gender

Date of Birth

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Means of Identification

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EMPLOYMENT DETAILS

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Position

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BUSINESS DETAILS

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CREDIT DETAILS

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Declaration

IN SUPPORT OF MY CREDIT APPLICATION, I SET OUT THE ABOVE INFORMATION, WHICH IS TRUE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT IF ANY OF THE ABOVE INFORMATION I HAVE PROVIDED IS FALSE, IT WILL LEAD TO AUTOMATIC DECLINE OF MY APPLICATION.

I AM 18 YEARS OF AGE AND ABOVE

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