BUSINESS FINANCE

DEVELOPMENT FINANCE CORPORATION LIMITED

CONDITIONS OF ACCEPTANCE

This application is accepted for consideration by ITHALA subject to the following terms and conditions.
1. Acceptance of this application by ITHALA in no way implies that a loan in terms of this application will be granted.
2. This application is subject to approval, which is made at the sole discretion of ITHALA in terms of its lending
criteria.
3. Notwithstanding the approval of a loan, certain loan conditions may still need to be met prior to funds being
advanced.
4. The applicant shall sign such documents and agreements as ITHALA shall require, which documents shall be
cancelled if this application is declined.
5. An initiation fee may be payable on signing of the business loan agreement in accordance with the National Credit
Act.
6. Should an own contribution in cash be required prior to the approval of this application, such own contribution will
be invested by ITHALA in an interest bearing account, for the benefit of the applicant. The interest shall be that as
paid by Ithala SOC Ltd on its Savings Accounts from time to time.
7. Where a valuation on fixed property is required, a non-refundable fee as specified by Ithala (where Ithala undertake
to value or have the property valued), may be payable prior to the valuation being conducted.
8. ITHALA is entitled to make whatever enquiries it feels necessary, including credit bureau to assess your application
for a loan. If a loan is approved, ITHALA is further entitled to register details regarding the conduct of your account
with credit bureaus.

CONTACT US: POSTAL ADDRESS ITHALA HEAD OFFICE REGIONAL OFFICES

PHYSICAL ADDRESS PO. Box 2801 Tel: (031) 907 8911 Durban : (031) 372 1200
29 Canal Quay Road DURBAN Fax: (031) 907 5606 Pietermaritzburg: (033) 345 8351
Point WaterFront 4000 Richards Bay: (035) 789 9682
Durban
www.ithala.co.za

1. LOAN REQUIREMENTS
1.1 Tick relevant type and complete amount requested
Asset Finance R : ................................................. Procurement Finance R : ............................................................
Working Capital R : .............................................. Commercial Property Finance R : ...............................................
Performance Guarantee R : ................................ Agri-Finance R: ...........................................................................
Franchise Finance R : ........................................... Stuctured Finance R: ...................................................................
Micro Finance R : ................................................................................................................................................................

1.2. Reason for which finance is required?: ...............................................................................................................................

1 Ithala is an authorised financial services and credit provider. FSP Licence No. 17125 | NCRCP No. 610
2. BUSINESS INFORMATION - TICK TYPE OF BUSINESS INFORMATION

2.1 Individual / Sole Proprietor Close Corporation Company

Partnership Co-Operative Trust

Other If Other Specify:

2. 2 New Business: Existing Business

Nature of Business:

2. 3 Language Preference English Zulu

2. 4 Method Of Contact Phone Email Letter

3 APPLICANTS BUSINESS PARTICULARS

Business Entity Name. : .................................................................................................................................................................

Trading Name : .................................................................................................................................................................

Id/Co/Cc/Tt/ Registration No : ................................................................................................................................................................

Physical Business Address : .................................................................................................................................................................

Business Postal Address : .................................................................................................................................................................

................................................................................................................................................................

.............................................................................................. Postal Code: ........................................

Telephone : .................................................................................................................................................................

Email Address : .................................................................................................................................................................

Fax : .................................................................................................................................................................

Mobile Number : .................................................................................................................................................................

Bankers : .................................................................. Telephone No.: ................................................................

Auditors : .................................................................. Telephone No.: ................................................................

Existing/Past Ithala : .................................................................................................. Type:....................................................

Accounts: Acc. No
..................................................................... Telephone No.: .............................................................

Tax Number : .................................................................................................................................................................

Vat Number : .................................................................................................................................................................

G.P.S CO-Ordinates :.....................................................................................................................................................

BEE Status : .................................................................................................................................................................

Subsidiaries & Associated : .................................................................................................................................................................

Companies
Name : .................................................................................................................................................................

Relationship : .................................................................................................................................................................

2 Ithala is an authorised financial services and credit provider. FSP Licence No. 17125 | NCRCP No. 610
Has any director shareholder / member been declared insolvent or have any recorded default/ judgement? If yes, provide

details, arrangements and/or date of rehabilitation. YES / NO

.........................................................................................................................................................................................................................

.........................................................................................................................................................................................................................

.........................................................................................................................................................................................................................

Note : This declaration is to be completed for the applicant entity and any person or entity providing surety for the loan

Applicants Name: ........................................................................................................................................................................................

Financial Details Of: ...................................................................................... Capacity: ............................................................................

Statement Of Assets And Liabilities As At: ......................................................................................... Signature: .................................

NON CURRENT ASSETS

Fixed Property - Description Of Asset Date of Purchase Price Paid R Current Value

3 Ithala is an authorised financial services and credit provider. FSP Licence No. 17125 | NCRCP No. 610
VEHICLE, MACHINERY AND EQUIPMENT

Description of Assets Cost Dep. Book Value Market Value

OTHER

Description of Assets Cost Dep. Book Value Market Value

Computers

Office Equipment

Breeding Livestock

Other

4 Ithala is an authorised financial services and credit provider. FSP Licence No. 17125 | NCRCP No. 610
 INVESTMENTS/INSURANCE POLICIES

Description Date Aquired Monthly Premium Surrender Value

CURRENT ASSETS

Current Value

Stock

Debtors

Cash (including positive bank balance)

A Total Assets R

LONG TERM LIABILITIES

Description Institution Original Amount Rem. Term Int.rate Instalment Current Balance

5 Ithala is an authorised financial services and credit provider. FSP Licence No. 17125 | NCRCP No. 610
 INSTALMENT AND LEASE TRANSACTIONS

Description Institution Original Amount Rem Term Int.rate Instalment Current Balance

OTHER LOANS

Description Institution Original Amount Rem Term Int.rate Instalment Current Balance

CURRENT LIABILITIES

Current Balance

Bank Overdraft

Tax Owed

Creditors

Other

B Total Liabilities R

C Net Asset Value (A-B) R

6 Ithala is an authorised financial services and credit provider. FSP Licence No. 17125 | NCRCP No. 610
 Sole Props & Close Companies Trust OTHER
LEGAL
Document Partnerships Corporations ENTITIES
Cc Members Co Directors Trust Trustees Founders

ID’s of owners, member, directors

Authorised representative

Marriage certificate of above

Founding Statements

Certificate to Commence Business

Memo & Articles of Association

Deed of Trust

Authorisation to act as Trustees

Constitution

Tax clearance

Proof of physical address (Business

and Individuals)
Proof of telephone number

Proof of cell phone number

Notice of Reg. office physical address

Notice of Reg. office postal address

Details of Assets and Liabilities

Curriculum Vitae of key individuals

OTHER DOCUMENTS REQUIRED (tick those required) COPIES OF:

Last 2 years annual statement Disclosure document of franchise

Latest management accounts Financial statements of franchisor

Last 6 months bank statements Buy back agreement

Business plan of the venture Contracts / Orders

Sale agreements Life assurance policy to be ceded

Lease agreements Existing comprehensive insurance policies

Quotes for goods to be financed Cashflow of contracts

Title deeds of property to be financed Certificate of registration of business vehicles

Proof of collateral to be provided Schedule of completed contracts and refer-

ences
Franchise agreement

7 Ithala is an authorised financial services and credit provider. FSP Licence No. 17125 | NCRCP No. 610
PERSONAL INCOME AND EXPENDITURE OF SURERITIES/ MEMBERS/SHAREHOLDERS

Name of applicant: ....................................................................................................... Date: ...................................../ ..............................

Monthly Income R

Salary

Salary of Spouse

Commissions

Investments

Other

Total Income

Monthly Expenditure R

Taxation (PAYE)

Medical Aid

Bond Repayments

Hire Purchase Agreements

Lease Agreements

Credit Card Accounts

Insurance Premiums

Loan Repayments

Electricity and Water

School fees

Rates & Taxes

Transport

Groceries

Clothing

Telephone

Other

Total Expenditure

Surplus Available

8 Ithala is an authorised financial services and credit provider. FSP Licence No. 17125 | NCRCP No. 610
1. Are you or your spouse (if married in community of property) currently under debt review? YES NO
2. Are you or your spouse (if married in community of property) currently insolvent or ever been declared insolvent?

YES NO
If Yes, date reliabilitated. Y Y Y Y M M D D
I/We hereby declare that this is a full true and correct statement of my/our financial position.

Dated: ............................................... at....................................................................................... .on the ............................................. day..

of .............................................................................................................. (Month) 20 .................. .Signature of applicant: .......................

4. PARTICULARS OF INDIVIDUALS

To be obtained for all sole proprietors, all partners, all members of C.C’s all shareholders holding more than 25% shares,
all persons providing personal deeds of suretyship, each beneficiary of a trust, each trustee, the founder of the trust, any
body representing the applicant and the chief executive

Surname: ....................................................................................... . First Name: .................................................................

.................................................................................................................................................................................................

.Type Of Identity: ............................................................................ . Gender Code:.............................................................

I.d. Number: ................................................................................... . Date Of Birth: ............................................................

Marital Status: ................................................................................ How Married: ............................................................

.Residential Address: .............................................................................................................................................................

......................................................................................................................................... Postal Code: ...............................

.Postal Address: .....................................................................................................................................................................

......................................................................................................................................... Postal Code: ..............................

.E-Mail Address: .....................................................................................................................................................................

.Home Telephone No: .................................................................... Code: .Cellular: ...........................................................

Relationship To Business: .............................................................. Percentage Interest: ....................................................

.Surname: ....................................................................................... .First Name: ..................................................................

Type Of Identity: ........................................................................... Gender Code: ............................................................

I.d. Number: ................................................................................... Date Of Birth: ............................................................

.Marital Status: ................................................................................ How Married: ............................................................

.Residential Address: .............................................................................................................................................................

......................................................................................................................................... Postal Code: ...............................

9 Ithala is an authorised financial services and credit provider. FSP Licence No. 17125 | NCRCP No. 610
Postal Address: .................................................................................................................................................................

................................................................................................................................... Postal Code: ................................

E-Mail Address: .................................................................................................................................................................

Home Telephone No: .................................................................... Code: .................... Cellular: ................................

Relationship To Business: .............................................................. Percentage Interest: ...............................................

Surname: ........................................................................... First Name: .........................................................................

Type Of Identity: ............................................................... . Gender Code: .....................................................................

I.d. Number: ....................................................................... Date Of Birth: .....................................................................

Marital Status: .................................................................... How Married: .....................................................................

Residential Address: .........................................................................................................................................................

................................................................................................................................... Postal Code: ................................

Postal Address: .................................................................................................................................................................

................................................................................................................................... Postal Code: ................................

E-Mail Address: .................................................................................................................................................................

Home Telephone No: .................................................................... Code: ..................... Cellular: ................................

Relationship To Business: .............................................................. Percentage Interest: ................................................

PARTICULARS OF COMPANIES, CC OR TRUSTS PROVIDING SURETY

Name .................................................................. Trading Name: ......................................................................................

............................................................................................................................................................................................

Reg. Number: ...................................................................................................................................................................

Physical Address: ...............................................................................................................................................................

............................................................................................................................................................................................

Registered Office Postal Address: .....................................................................................................................................

Registered Office Physical Address: ..................................................................................................................................

................................................................................................................................... Postal Code: ................................

Postal Address: ..................................................................................................................................................................

................................................................................................................................... Postal Code: ................................

E-Mail Address: .................................................................................................................................................................

Telephone No. ................................................................. Code: ............................. Cellular: .........................................

10 Ithala is an authorised financial services and credit provider. FSP Licence No. 17125 | NCRCP No. 610
5.. ITEMS TO BE FINANCED (include values) VALUE
Description: ............................................................................................................................... R .....................................................
..................................................................................................................................................... R ....................................................
..................................................................................................................................................... R ....................................................
..................................................................................................................................................... R ....................................................
..................................................................................................................................................... R ....................................................

(N.B. For plant and machinery loans provide as much details as possible about the
transaction including specifications, quotations, etc.)

6. SECURITY OFFERED VALUE

Description: ............................................................................................................................... R .....................................................
..................................................................................................................................................... R ....................................................
..................................................................................................................................................... R ....................................................
..................................................................................................................................................... R ....................................................
..................................................................................................................................................... R ....................................................

7.. ASSETS TO BE INVESTED / OWN CONTRIBUTION

Cash: ......................................................................................................................................................................................................
Moveables: .............................................................................................................................................................................................
Stock: ......................................................................................................................................................................................................
Other: ......................................................................................................................................................................................................

8.. MARKETING INTELLIGENCE

8.1 How did you hear about Ithala?

Newspaper: ................................................ Name of Newspaper: ....................................................................................

Radio: ........................................................... Name of Radio Station: ................................................................................

Magazine: ..................................................... Name of Magazine: ......................................................................................

Personal Contact: ..................................... Name of Person: ...........................................................................................

Property Broker: ......................................... Name of Company/Person: ..........................................................................

Other: ........................................................... How:..................................................................................................................

8.2 From time to time we would like to send you information about our other products or services which we believe may be

of interest to you. If you would like to recieve this information tick the relevant box below. Please send me this information

by: Fax: .............................................................. SMS: ......................... Email: .......................................................

9. DECLARATION

I, (full name) ............................................................................... confirm the accuracy of the particulars herein given and

agree that they form the basis upon which the application is to be considered and that any discrepancy subsequently

discovered may result in the withdrawal of any loan facilities that may be offered.

Date: ....................................................................... Signed: .................................................................................................

For And On Behalf: ..................................................................................................................... (Name Of Applicant Co.)

Signature: ...............................................................................................................................................................................

11 Ithala is an authorised financial services and credit provider. FSP Licence No. 17125 | NCRCP No. 610