Home Loan Application Form - Integer

1
Home Loan Application Form
1.1. General application information
Application type Individual Joint Legal entity
Type of loan Switch New loan Bond free property Further loan Re-advance
Use of property Primary residence Investment/rent Holiday/second residence
Are you a first time home-owner? YES NO Do you have an existing home loan?
Number of applicants 1 2 3 4 5
Loan required R , ,
Estimated market value
Registration amount R , ,
Term of loan 5 10 15 20 years
Deposit amount
Bond to be registered in name of
R , ,
Is the property to be registered in a legal entity’s name? YES NO
If yes, entity name CO/CC/Trust no.
Entity type Trust Company Closed corporation
1.2. Home loan features
Capital Deferment
YES NO
Skip a Month YES NO If yes, specify month to skip
InterCash - Bridging Finance YES NO If yes, outstanding balance at current institution
1% Credit facility YES NO (Terms and conditions apply)
1.3. Repayment details
Bank name for debit order Account name
Account number Branch name
Account type Current Savings/Transmission
Repayment options Debit order Salary Stop order
Instalment day of month 1st 7th 17th 25th 28th
Statement delivery method Direct Mail Email
2.1. Property details
Property type Freehold Leasehold Sectional title/Duette
Street number Street name
Suburb / Township City
Province Postal code
Erf size m 2 Hectare
Erf number
GenerAL AppLicAtion DetAiLs
2.2. Sectional title details
propertY DetAiLs
Name of complex Unit number
Section number Parking bay number
Garage number Outbuilding number
2.3. Contact person for valuation
Name Tel no.
Cell number Fax no.
2.4. Transfer attorney details
Attorney name Tel no.
YES NO
Attorney contact name Fax no.
Integer (Pty) Ltd; Reg. no. 2007/008108/07; Directors: MA Barnes (Chairman), SJ Stockley (CEO)*, CC Carter, DM Lawrence (alternate: N Job) *Executive
T: 0861 INTEGER or 0861 4 66 66 4 • F: (021) 413 1558 • 120 Loop Street Cape Town 8001, South Africa • Postal: Suite 233 Private Bag x335 Cape Town 8000, South Africa
www.integer.co.za
PAGE of
R , ,
R , ,
(Approximate settlement amount)

2
Home Loan Application Form
PAGE of
3.1. General details
Title
First names
Surname
MAin AppLicAnt DetAiLs
co-AppLicAnt / suretY DetAiLs
ID type
ID/Passport number*
ID document Passport ID document Passport
Date of birth D D / M M / Y Y Y Y D D / M M / Y Y Y Y
Gender* Female Male Female Male
Marital status Married Single Divorced Married Single Divorced
Widowed Traditional Common law Widowed Traditional Common law
If married, how?
Number of dependents*
COP ANC COP ANC
Ethnic group* White Black Brown Other White Black Brown Other
Nationality* Domestic Foreign Domestic Foreign
If foreign, foreign resident permit no.
Work permit number
Date of issue
Current street address
D D / M M / Y Y Y Y D D / M M / Y Y Y Y
Postal code Postal code
Current residential status Owner Tenant Boarder Other Owner Tenant Boarder Other
Since date D
Postal address
D / M M / Y Y Y Y D D / M M / Y Y Y Y
Tel number
Cell number
Fax number
Email
Is surety offered?
Postal code Postal code
YES NO YES NO
3.2. Financial history
Are you currently under debt counselling? YES NO
YES NO
Have you ever been declared insolvent? YES NO
YES NO
If yes, date rehabilitated? D D / M M / Y Y Y Y D D / M M / Y Y Y Y
Are you aware of any adverse credit listing?
If yes, please specify
YES NO
YES NO
Are you bound by any suretyship?
If yes, please specify
YES NO
YES NO
3.3. Employment details
Occupation status Full time Part time Contract Full time Part time Contract
Pensioner Self-employed Temporary Pensioner Self-employed Temporary
Student Housewife Unemployed Student Housewife Unemployed
Occupation level Management Senior management Management Senior management
Supervisor Junior position Supervisor Junior position
Skilled worker Semi skilled Unskilled Skilled worker Semi skilled Unskilled
Business/Employer name
Employment sector
Highest qualification Matric Grade 7-11 Diploma Matric Grade 7-11 Diploma
Degree Honours Masters Doctorate Degree Honours Masters Doctorate
*Integer is required to request this information to assist the Government in monitoring lending practices in terms of the Home Loan and Mortgage Disclosure Act, 2000

3
Home Loan Application Form
PAGE of
Occupation
Employer address
Tel number
Contact person
Employee number
MAin AppLicAnt DetAiLs
co-AppLicAnt / suretY DetAiLs
Postal code Postal code
Employed since D D / M M / Y Y Y Y D D / M M / Y Y Y Y
Frequency of income Monthly Weekly Fortnightly Monthly Weekly Fortnightly
If period with current employer is less than 12 months:
Name of previous employer
3.4. Monthly income
Basic salary
Car allowance
Average commission
Rental income
Maintenance income
Investments income
Overtime
Other income
GROSS INCOME
Less pension
Less medical aid
Less tax
Less UIF
NETT INCOME
3.5. Monthly expenses
Vehicle instalment
Rent
Credit card instalments
Personal loans
Existing home loan instalment
Retail accounts
Municipal rates
Alimony/Family maintenance
Groceries
School & university fees
Transport costs
Household maintenance/Security
Insurance/Policies
Telephone & cellphone
Domestic wages
Other expenses
TOTAL EXPENSES
Quarterly Bi-annually Quarterly Bi-annually
Years Months with previous employer Years Months with previous employer

4
Home Loan Application Form
PAGE of
3.6. Other
Do you wish to receive additional marketing material?
Where did you hear about Integer?
cLient DecLArAtion
Direct agent Direct agent
Mortgage originator Mortgage originator
Printed media Printed media
Radio Radio
Press Word of Mouth Flyer at the robot Press Word of Mouth Flyer at the robot
Web TV Branded vehicles Web TV Branded vehicles
I/We declare that to the best of my/our knowledge the particulars set out in the application form are and/or any supporting
documentation supplied by me/us are true and correct and that no information has been withheld which might reasonably affect the
decision of Integer in granting of a loan. I undertake to inform Integer should any information change or have changed at any time
prior to the finalisation of the loan.
MAin AppLicAnt DetAiLs
YES NO YES NO
I/We hereby authorise Integer to perform a credit reference check on me/us with one or more credit bureau/s and to furnish or to
disclose any information arising from my/our performance under any loan agreement entered into as a result of this application to
any credit bureaus.
Main applicant name Signature Date
Co-applicant name Signature Date
co-AppLicAnt / suretY DetAiLs