Bridging Finance Pension / Provident
Application Pre-Assessment

Client Full Names       ________________________________________________________________
ID Number                    ________________________________________________________________
Email Address             ________________________________________________________________
Phone Number            ________________________________________________________________
Fax Number                  ________________________________________________________________
Cell Number                 ________________________________________________________________
Bank                               ________________________________________________________________
Branch Code                ________________________________________________________________
Account Number          ________________________________________________________________
Account Holder Name     ______________________________________________________________

Has the Applicant resigned yet?             Y/N    __________
Has the applicant completed his/her Pension/ Provident fund withdrawal notice     Y/N  __________
In the case of the withdrawal notice having been completed, indicate, when anticipated payout ?  ____/_____/ 2008

What is the total value of your pension                                                             R_______________

How much of the pension, would you like to bridge. Approximately           R_______________

Documents Required

ID.
Last pay-slip.
Letter of appointment with new company (where applicable).
Pension / Provident Fund Statement.
Acknowledgement of receipt of withdrawal notice (where applicable).



CONSENT :

I hereby authorize and give my consent to (Credit Provider) __________________________________
to make enquiries from time to time through any credit bureau or similar institution as to my personal
circumstances, my credit history and credit worthiness.

I consent to and authorize (Credit Provider) ______________________________________________
disclose the information provided herein, the information obtained from any credit bureau or institution
referred to above, as well as my payment and credit performance, to any other person, company or
bureau without further reference to me.

Borrowers Signature  _________________________                     Witness ___________________________

Date _____________________


New Heights 510 (Pty) Ltd t/a New Heights Finance
Directors: RC Pretorius (B.Tech. M.B.A.), GG Bowman Reg No 2003/019600/07 VAT 4490210012
PO Box 1583, Wandsbeck, 3631. Fax: 0866 283669 info@nhfinance.co.za