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Do you receive a Social grant? Ontvang u �n maatskaplike toelae? Applicant�s race Kli�ntse ras ipe ID ompany Maatskappy Scheme code Skema kode Use Assessment Gebruik beoordeling Nationality ountry passportissued Land paspoortuitgereik Van no/Passportnumber D-no/Paspoortnommer Date of birth Geboortedatum Marital status,contract Huwelikstaat,kontrak assport aspoort Enkel Cop GVG DDMM C/EC/EY/JY/J Number of dependants Place of Residence erblyfplek Divorced Geskei emporary Resident delike inwoner esidentof Namibia,Lesotho,Swaziland Inwoner van Namibi�,Lesotho,Swaziland emporary ResidentPermitnumber delike inwoner-permitnommer ermitexpiry date ermitvervaldatum orrespondence Language ostMatric Qualification Naskoolse kwalifikasie ABSA 3740 (Pilot) uthorised Financial Services Provider/Gemagtigde Finansi�lediensteverskaffer � Registered CreditProvider/Geregistreerde Kred Non-resident Nie-inwoner If YES,type of PostMatric Qualification Indien JA,tipe naskoolse kwalifikasie frikaans Separated idow/Widower eduwee/Wewenaar Bank Limited/Beperk, Reg No 1986/004794/06 ension-supported Housing Loan (Application Form)/ ensioengesteunde Huislening (Aansoekvorm) Employee-guaranteed Housing Loan (Application Form)/ Aansoek vir Werknemergewaarborgde (Aansoekvorm) ension-supported Housing Loan LatestPayslip Employee-guaranteed Housing Loan Aansoek vir Werknemergewaarborgde Huislening CSA Ref CSA-verw 011 350 1705/1747/6354 pshl.gsales@absa.co.za Gauteng North 012 303 2270 or 012 310 7664/698 pshl.northsales@absa.co.za ape Regions: 021 405 7878/7783/7935 pshl.capesales@absa.co.za ZN and Free State: 031 366 9277/9198 pshl.kznsales@absa.co.za CONTACT Swar oloured Wit Indi�r Other (Please specify) Ander (Spesifiseer asseblief) tificate months Sertifikaat Degree Graad Doctorate Doktoraal ostGraduate Diploma months Nagraadse diploma YES NEE YES NEE er Declared insolvent? Al ooitinsolventverklaar Property address (if differentto residential address) Eiendomsadres (indien verskil van woonadres) wn/City Erf nommer r UnitNo wn/City wn/City Occupation Beroep CONTACT esidential address esidensi�le adres ostcode oskode elefoonnommer (Huis) elephone number (Work) elefoonnommer (Werk) Pos elefoon oltyds emporary Employee number Contract Kontrak Employmentstatus erkstatus ondslidmaatskapnommer Selfoonnommer Fax Faks E-mail address E-posadres YES NEE NSURE/ONSEKER Takeover YES NEE ostcode oskode ostal address osadres New loan amount Nuwe leningsbedrag Application loan term in months Aansoekleningstermyn in maande xisting accountnumber Bestaande rekeningnommer otal loan amount otale leningsbedrag xisting PSHL balance Bestaande PGHL-saldo Depositon Property oop van grond chase of Property oop van eiendom enovations/Enhancements Monthly repayment YES NEE YES NEE N RRR otal Expenses CLIENT UITGAWES Mortgage/Rent ersoonlike lenings In store accounts inkelrekenings Bank charges Bankkoste Mediese Fonds Other (please specify) Ander (spesifiseer asseblief) otal Income otale Inkomste oan/Overdraft ening/Oortrekking I/We acknowledge thatthe information supplied by me/us shall constitute the basis on which my/our application is to be considered and thatall such information is of material importance and directly relevantto the consideration of my/our application. I/We warrantthatall information I/we supplied is to the bestof my/our knowledge and belief true and correctin all material respectand I/we is/are notaware of any other information which,should itbecome known to the Bank,would affectthe consideration of our application in any way. I/We agree thatthe Bank may make inquiries to confirm any information provided by me/us and thatthe Bank may obtain information from any creditbureau when assessing my/our application or atany time during the existence of my/our account.The Bank may disclose the existence of my/our accountto any creditbureau,sharing positive and negative information aboutmy/our account. Absa Bank Ltd (�Absa�) is committed to complying with national and international law,rules and regulations and policies regarding the combating of criminal activities,money laundering and terroristfinancing.All applications and all information concerning the customer,are therefore subjectto verification,processing and screening and Absa may be obliged to decline certain applications.In addition,upon the acceptance of an application, all information,instructions and transactions for and on behalf of the customer will be subjectto continuous screening which may prohibit,limitor delay the execution thereof and which may oblige Absa to terminate its relationship with the customer.To the extent permissible,Absa shall advise the customer of any prohibitions or limitations on such applications,instructions or transactions.Absa,or its respective affiliates,employees, officers,and directors,shall notbe liable for any special,punitive,indirect,or consequential losses or damages,including,withoutlimitation,loss of profits or any anticipated savings. I declare thatthe proceeds of the loan for which I am applying will be used for housing purposes as described in section ) of the Pension Funds Act, or any eplacementlegislation. I declare thatthe property is/will be occupied by me and/or my spouse and/or my/our dependant(s). I declare that am the lawful owner and my spouse are lawful owners y spouse is the lawful owner of the property for which the proceeds of the loan will be used. Ek/Ons erken datdie inligting watdeur my/ons verskaf is die grondslag uitmaak waarop ons aansoek oorweeg sal word en datalle sodanige inligting van wesenlike belang is en Customer Communications and Consent The Absa Group diligently guards all personal and financial information relating to our customers.Your dealings with us are held in the strictestconfidence and your privacy as an Absa customer is one of our highestpriorities.AtAbsa,we do notsell or distribute any of our customer lists to third parties,unless we are required to do so by law. In keeping with this commitment,we need your consentto send you information on the Absa Group�s range of products and services as well as any special promotions from us,or promotions on behalf of other carefully selected parties,which we believe would add value to your finances or lifestyle.We mightalso contactyou to onductresearch in order for us to improve our products and services to you. If you would like us to communicate with you in this regard from time to time, Kli�ntkommunikasies en -toestemming Die Absa Groep beskerm alle persoonlike en finansi�le inligting oor ons kli�nte baie Applicant�s Signature Aansoeker se Handtekening Signed at Signature on behalf of Employer (if applicable) Handtekening namens Werkgewer (indien van toepassing) the Absa Group to utilise my/our confidential information within the Group and to communicate with me/us from time to time garding products,services,research and special offers thatthey believe will be of interest. I am/we are happy to receive such communication via the following to receive any communication from the Absa Group on products,services or special offers and understand thatthis means that I/we will notbe keptinformed of products and services thatmay be of alue to me/us.I/We will therefore nothold the Absa Group liable for any opportunities I/we may miss as a resultof this decision. Creditworthiness information Absa is occasionally approached by creditproviders or third parties who are ttempting to evaluate your creditworthiness when you apply for creditor wish to enter into a creditagreementwith such a party.We can�tgive them this information withoutyour permission to do so. to provide information relating to my creditscore or creditworthiness to third parties who may requestthis information. give Absa permission to provide information relating to my credit score or creditworthiness to any third parties who may requestthis information. JA, wil gr ommunikasie van die Absa Groep oor produkte,dienste of OESTEMMING In so far as my consentis required in terms of the provisions of the Matrimonial Property Act, (ActNo ) for the conclusion of a CreditAgreementfor this Pension- supported Housing loan on Absa Bank Limited�s normal/standard terms and conditions by my spouse. (full name and ID No of applicant) to whom I am married in community of property,I, hereby give such consentand acknowledge the liability of our jointestate in this regard. Signed at Signature Handtekening WITNESSES (Signature) (ID No) (Signature) (ID No) (full name and ID No of spouse) ir sover as watek,my toestemming ingevolge die bepalings van die Wetop Huweliksgoedere, (ID-no) (Handtekening) (ID-no) (volle name en ID-no van aansoeker)