Credit Application Form - Scania

Scania Finance Southern Africa (Pty) LtdLEASE APPLICATION FORMAll fields are mandatory to be fully completed1. APPLICANTIs Applicant a SOLE PROPRIETOR? Y / N Is Applicant’s nett asset value above R 1 000 000.00 ? Y / NIs Applicant a PARTNERSHIP ? Y / N Is Applicant’s annual turnover above R 1 000 000.00 ? Y / NIs Applicant a COMPANY ? Y / N Is the Applicant currently under debt review in terms of the National Credit Act ? Y / NIs Applicant a CLOSE COPORATION ? Y / N Is the Applicant an unrehabilitated insolvent? Y / NIs Applicant a TRUST ? Y / N Are there 3 or more Trustees ? Y / NIs the TRUSTEE a juristic person ? Y / N Are there 1 or 2 Trustees? Y / NApplicant NameTrading NameCompany registration number / ID No.VAT registration numberFounding DateHow long have you been in business?Do you do cross border Transport?Y / N If Yes, which Areas -Cross border Insurance held? Y / N Broker ? -Brief Background HistoryCore Business:Industry SectorsCommoditiesTransportedRegistered Postal AddressRegistered Physical AddressOperating Postal AddressOperating Physical AddressOperating Premises - Mark applicable boxOwned / Leased / RentedIf owned in what name?Landlord - NameLandlord - Telephone noLease / Rent YearlyRTelephone No.Fax No.Area Code:Area Code:Number:Number:Contact Person & Cell No.Email Address for Electronic Invoices2. APPLICATION FOR FINANCEModel of VehicleQuantityApproximate Value of VehiclesExcluding VATReachFinancing ToolOperating Lease / Financial Lease Period of Financing - monthsDeposit:CashTrade-inAddition to Fleet or ReplacementVersion 3 – Feb 2013Page 1 of 4

3. MEMBERS / DIRECTORS / SHAREHOLDERS / OWNERS / TRUSTEE / BENEFICIARIES OF TRUSTFull NamesID NumberCountry of CitizenshipMarital Status M = Married D = Divorce S = SingleMarital Contract I = In community of property A = Antenuptial Contact% InterestTitle/Role in companyPhysical Address(Not company address-residential address)Telephone No. Area Code: Number: E-Mail address:Cell NoNumber:Signature:Full NamesID NumberCountry of CitizenshipMarital Status M = Married D = Divorce S = SingleMarital Contract I = In community of property A = Antenuptial Contact% InterestTitle/Role in companyPhysical Address(Not company address-residential address)Telephone No. Area Code: Number: E-Mail address:Cell NoNumber:Signature:Full NamesID NumberCountry of CitizenshipMarital Status M = Married D = Divorce S = SingleMarital Contract I = In community of property A = Antenuptial Contact% InterestTitle/Role in companyPhysical Address(Not company address-residential address)Telephone No. Area Code: Number: E-Mail address:Cell NoNumber:Signature:Full NamesID NumberCountry of CitizenshipMarital Status M = Married D = Divorce S = SingleMarital Contract I = In community of property A = Antenuptial Contact% InterestTitle/Role in companyPhysical Address(Not company address-residential address)Telephone No. Area Code: Number: E-Mail address:Cell NoNumber:Signature:Version 3 – Feb 2013Page 2 of 4

4. PERSON AUTHORISED TO TRANSACT ON BEHALF OF COMPANY / CLOSE CORPORATION / TRUST / CLIENT/PARTNERSHIPFull NamesID NumberCountry of CitizenshipTitle/Role in companyResolution to be provided (Compulsory)Physical Address(Not company address-residential address)Telephone No. Area Code: Number: E-Mail address:Cell No5. BANKING DETAILSNumber:Signature:Account NameBANKBRANCH CODE /BRANCH NAMEACCOUNT NUMBEROVERDRAFT LIMIT6. INSURANCEDid one of Scania Representatives explain Scania Insurance to you?Do you have your own InsuranceY / NY / NCan Scania Insurance give you a Quote Y / N Customer signature – Confirm Insurance was discussed7. CONSENTWe, the applicant, hereby give Scania Finance consent:1. to supply Scania SA – Credit Department with all financial information as supplied toallow Scania SA to quote on Repair & Maintenance and to consider an openaccount;2. to do the necessary Credit and Kreditinform checks from time to time;3. to list the applicant in the event of default with any credit bureau at the sole discretionof Scania Finance;4. to cede any claim by the applicant’s insurer;5. to provide updated financials and ancillary information on demand and/or in the eventthat any of the information provided herein changes;6. to approach the applicant’s vehicle tracking service provider without prior consent toestablish the whereabouts of the vehicles which form the subject matter of thisapplication.Customer signatureWe declare that no judgment has been obtained against the applicant or its directors or trustees in the last five years.We warrant that this application constitutes our actual financial position, and we are capable of fulfilling the liabilities arisingfrom this application.The facts and figures herein contained are current, true and correct and may be relied upon by Scania Finance.Scania Finance reserves the right to approve or decline the application as per their approved Credit Policy.No agreement between the parties will be enforceable unless reduced to writing and signed by all parties.Please refer to Annexure “A” for the comprehensive list of application requirements as well as requirements dictated by FICA.Please note that this application will not be considered if it is not signed by theapplicant/s.City: ___________________________ Date: _____________________________Signature: _________________________Company stamp:Who hereby warrants his authority to sign on behalf of the CO/CC/Trust/PartnershipCONTACTS:Northern & Eastern RegionWikus Jordaan082 808 8851wikus.jordaan@scania.co.za(011) 822 3962 FaxInsurance Coordinator:Kevin Meyer082 317 4840kevinm@scania.co.za(011) 908 7023 FaxVersion 3 – Feb 2013Gauteng Region Gauteng:Rikus Gouws079 510 5379rikus.gouws@scania.co.za(011) 908 7023 FaxAlicia Weldon082 317 9249alicia.weldon@scania.co.za(011) 822 3962 FaxBennie Vorster (Bus / Fleet)082 808 8852barend.vorster@scania.co.za(011) 908 7023 FaxCentral & Free State Region:Leon Kriel083 642 5556leon.kriel@scania.co.za(086) 625 1294 FaxKZN & Eastern Cape Region:Suren Naicker082 825 2975surendra.naicker@scania.co.za(031) 705 8088 FaxWestern & Northern Cape Region:Rupert Klynsmith071 670 9431rudolph.klynsmith@scania.co.za(021) 987 0230 FaxPage 3 of 4

Annexure “A”In order to render an efficient service in granting any credit and adhere to the South African Laws, Scania Finance SA (Pty) Ltd. needs thefollowing documentation as prescribed by FICA (Financial Intelligence Centre Act 2001, promulgated by the South African Government)for the following applicants (entities):Please note that NO application will be considered if any of the required documentationis outstanding. Ensuring that we receive the following will ensure quicker response time.DOCUMENTS REQUIRED FOR APPLICATION• Current audited financial statements.• Previous 2-years audited financial statements.• Up-to-date Management accounts• Projected Cash flow for next 12 months• Asset register – Showing asset description, value and outstanding debt• Copy of a cancelled cheque and 6 months bank statements.• Debtors age analysis.• Creditors age analysis• Organogram of the company.• Personal/Audited financials on offered sureties• Copies of transport contract/s.• Company letterhead showing all addresses, contract numbers & directors.DOCUMENTS REQUIRED FOR FICACOMPANIES - (PTY ) LTD• Company statutory documentation- Certificate of incorporation (form CM1/COR14.3), Memorandum ofIncorporation(CM2/COR15.3)- Note of Registered Office and Postal Address (form CM22) bearing thestamp of the Registrar of Companies and signed by the companysecretary.- Register of active Directors (CM29/COR15.2)- Any other forms amending company information, e.g. CM 9• Person who exercises executive control over company,e.g. Directors or CEO- Certified ID(for SA citizen) or Valid Passport (Foreign Residents)- Proof of residential address – e.g. Municipal rates and taxes invoice orTelkom account.(must show physical address)- Contact details• Documentary evidence authorising any person to act on behalf of thecompany, e.g.- Resolution/mandate/minutes- Certified ID(for SA citizen) or Valid Passport (Foreign Residents)- Contact details• Company Income tax & VAT registration certificates.• Proof of company address – e.g. Municipal rates and taxes invoice orTelkom account.(must show physical address)• Share Certificates• Shareholder/s details >=25% – Natural Person- Certified ID(for SA citizen) or Valid Passport (Foreign Residents)- Proof of residential address – e.g. Municipal rates and taxes invoice orTelkom account.(must show physical address)- Current statement of assets and liabilities of each.- Contact Details• Shareholder/s details >=25% – Juristic Entities- Certificate of incorporation (form CM1), Memorandum of Incorporation(CM2)- Note of Registered Office and Postal Address (form CM22) bearing thestamp of the Registrar of Companies and signed by the company secretary.- Register of active Directors (CM29)- Any other forms amending company information, e.g. CM 9- Share certificates.- Company income tax & VAT registration certificates.- Proof of company address – e.g. Municipal rates and taxes invoice orTelkom account.(must show physical address)- Current audited financial statements.- Previous 2-years audited financial statements.- Management account for the current year.- 6 months bank statementsTRUSTS• Certified copies of Trust Deed’s• Letter of Authority issued by Master of the High Court to each Trustee• Documentary evidence authorising any person to act on behalf of the Trust,e.g. -Resolution/mandate/minutes- Certified ID(for SA citizen) or Valid Passport (Foreign Residents)- Proof of residential address – e.g. Municipal rates and taxes invoice or Telkomaccount.(must show physical address)- Contact details• Trust Income Tax & VAT registration certificates.• Proof of Trust address – e.g. Municipal rates and taxes invoice or Telkomaccount.(must show physical address)• Information Required on –Donor / Founder, Trustees, Named Beneficiaries:- Certified ID(for SA citizen) or Valid Passport (Foreign Residents)- Proof of residential address – e.g. Municipal rates and taxes invoice or Telkomaccount.(must show physical address)- Current statement of assets and liabilities of each- Contact DetailsCLOSE CORPORATIONS• Close Corporation statutory documentation- Founding Statement (form CK1)- Notice of Registered Office and Postal Address (form CK2) bearing thestamp of the Registrar of Companies and signed by the members.• Person who exercises executive control over CC if not a member- Certified ID(for SA citizen) or Valid Passport (Foreign Residents)- Proof of residential address – e.g. Municipal rates and taxes invoice orTelkom account.(must show physical address)- Contact details• Documentary evidence authorising any person to act on behalf of theCC, e.g.- Resolution/mandate/minutes- Certified ID(for SA citizen) or Valid Passport (Foreign Residents)- Contact details• Company Income tax & VAT registration certificates.• Proof of company address – e.g. Municipal rates and taxes invoice orTelkom account.(must show physical address)• All Members of CC – Natural Person- Certified ID(for SA citizen) or Valid Passport (Foreign Residents)- Proof of residential address – e.g. Municipal rates and taxes invoice orTelkom account.(must show physical address)- Current statement of assets and liabilities of each.- Contact Details• All members of CC – Juristic Entities- Certificate of incorporation (form CM1), Memorandum of Incorporation(CM2)- Note of Registered Office and Postal Address (form CM22) bearing thestamp of the Registrar of Companies and signed by the company secretary.- Register of active Directors (CM29)- Any other forms amending company information, e.g. CM 9- Share certificates.- Company income tax & VAT registration certificates.- Proof of company address – e.g. Municipal rates and taxes invoice orTelkom account.(must show physical address)- Current audited financial statements.- Previous 2-years audited financial statements.- Management account for the current year.- 6 months bank statementsSOLE PROPRIETOR & INDIVIDUALS• Independent documentary evidence reflecting the Business/Trading Name,e.g. Letterhead, business Inv.• Certified ID(for SA citizen) or Valid Passport (Foreign Residents)• Proof of operating physical address – e.g. Municipal rates and taxesinvoice or Telkom account.(must show physical address)• Proof of current residential address – e.g. Municipal rates and taxesinvoice or Telkom account.(must show physical address)• Income tax & VAT registration certificates.• Documentary evidence authorising any person to act on behalf of theClient e.g.- Resolution/mandate/minutes- Certified ID(for SA citizen) or Valid Passport (Foreign Residents)- Proof of residential address – e.g. Municipal rates and taxes invoice orTelkom account.(must show physical address)- Current statement of assets and liabilities of each- Contact details- SA Income Tax Registration NumberVersion 3 – Feb 2013Page 4 of 4