(To be completed by each Director/Member/Shareholder/Trustee)
LIABILITIES
ASSETS
I consent that I am not/have not been:
I declare that:
Protection of personal information:
FINSA is subject to the POPI Act and undertakes to protect personal information and to only use such information for the purpose of finance applications.
I hereby declare and warrant that the information I have provided about myself in this statement is true and correct in every detail.
I hereby give consent to FINSA to record, store and process the information provided in this form.
I agree that Financial Services of South Africa (Pty) Ltd may obtain and use my information from third party qualification data providers to conduct an assessment to determine my eligibility for, and the appropriateness of, the supply of this credit solution applied for.
Thank you for submitting your personal Assets & Liabilities Statement.
