Application Form

    Fields marked with an * are required

    Personal Information

    Full Name(s) *

    Surname *

    Title *

    Gender *

    Income Tax Number *

    ID Type *

    ID Number *

    Type of Residence *

    Marital Status *

    Country of Marriage

    City of Birth *

    Number of Dependents *

    Ethnic Group *

    Highest Qualification *

    Nationality *

    Country of Birth *

    Home Language *

    Contact Details
    Home Contact Number

    Cellphone *

    Work Contact Number *

    Email *

    Address Details
    Physical Address *

    Postal Address

    Residential Status *

    Occupied Since *

    Employment Details
    Employment Status *

    Occupation Level *

    Job Title *

    Do you work in South Africa

    Employer Name *

    Employer Address

    Employee Number *

    Years Employer Operating

    Length at Current Employer *

    Is your current employment less than 3 years?

    If Yes...
    Previous Employer

    Length of Previous Employment

    Make and Model Number


    Fixed Property


    Consent to At National Home Loans (Pty) Ltd

    I hereby appoint the Originator as my sole agent and on my behalf to submit to all Financial Institutions in line with the requirements as discussed, in order to obtain mortgage loan finance for the property specified on this application form. I hereby consent to the Originator using, storing and sharing my personal information (as set out on this form) with companies within its group and with registered credit providers as well as its service providers. I further agree to receive information about other products and services that the Originator thinks may be of interest to me. I acknowledge that I have the right to opt-out of such future communications.

    Consent to Electronically obtain Account Statements from Financial Institutions: For the purpose of assessing your credit/finance application your consent is needed to obtain your bank statement(s) directly from Absa, Nedbank and Standard Bank. The financial institutions involved will exchange no further information than your bank statements and these will be safeguarded and not used for any other purposes. Bank account statements obtained will also be limited to the period necessary to assess the credit/finance application. Your signature below confirms you have provided the required consent for retrieval of your bank statements for purposes of this application and if there is a problem with the electronic retrieval of some or all of the required bank statements for any reason, the credit provider will contact the Mortgage Originator to source a separate form for the account statements.

    Please note that by selecting yes at the consent on the application you will give us the full mandate to handle your bond application and you will not make use of any other bond originator or financial institution.

    Do you consent to this?

    The advantages of putting down a deposit when financing a home has been discussed with me. I/we hold no other citizenships and residencies 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. I warrant that all the information I supplied is to the best of my knowledge and believe true and correct in all material respects. I am not aware of any other information which, should it become known to the Financial Institution, would affect the consideration of my application in any way. I agree that the Financial Institution may provide any information pertaining to the Loan applied for to the Originator during the application process. I hereby authorize the Financial Institution to have access to my credit bureau records and to furnish and/or to disclose any information arising from any agreement entered into with the Financial Institution to any such credit bureaus. I/We further irrevocably consent that the Bank can request my/our payslips for auditing purposes from my/our employer or any third party

    Do you consent to this?

    Print your name