LENDTEL secure application

Loan Acceptance Form

Use this form only after receiving a formal LENDTEL quotation or approval document. Review the agreement before confirming acceptance.

Private applicationYour information is submitted directly through the LENDTEL form workflow.

Application progress Step 1 of 2

Step 1 of 2

Enter the details shown on your quotation or approval document.

Full names*

ID / passport number*

Loan reference number*

Email address*

Phone / mobile*

Residential address*

Approved loan amount (R)*

Monthly repayment amount (R)

Preferred monthly debit date*

Preferred timing to settle outstanding approval legal compliance deposit*

Selected date (if applicable)

Choose a date within 21 days of today.

Step 2 of 2

Complete only when debit order is the repayment method stated in your agreement.

Bank name*

Account holder*

Account number*

Account type*

Branch code

Enquiry or additional information

Signed quotation or agreement

Choose filePDF, JPG, PNG, DOC or DOCX

Optional PDF or image.

I confirm that I have read and accepted the terms in my formal LENDTEL quotation or agreement. *