SASSA Loan Application Form "*" indicates required fields Step 1 of 3 - Personal Information 0% Personal InformationFirst Name (s)SurnameID no.Date of Birth DD slash MM slash YYYY Cell no.Landline no.Marital StatusSpouse Full Name Contact Number Next of Kin Full Name Contact Number Not living with you - relative / friendAddressAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code WorkEmployee NumberName of CompanyCompany Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Contact number (HR Manager)Years of servicePosition in CompanyPrevious employer if less than 3 yearsEmployee NumberName of CompanyCompany Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Contact number (HR Manager)Years of servicePosition in Company Financial InformationGross Monthly EarningsMonth 1Month 2Month 3DeductionsSITE / PAYEMonth 1Month 2Month 3UIFMonth 1Month 2Month 3PensionMonth 1Month 2Month 3Medical AidMonth 1Month 2Month 3InsuranceMonth 1Month 2Month 3Other (garnishee, etc)Month 1Month 2Month 3Net SalaryMonth 1Month 2Month 3ExpensesFoodMonth 1Month 2Month 3School Fees / Tertiary Education FeesMonth 1Month 2Month 3Bond / RentMonth 1Month 2Month 3InsuranceMonth 1Month 2Month 3Medical AidMonth 1Month 2Month 3Water, Electricity and RatesMonth 1Month 2Month 3Clothing AccountsMonth 1Month 2Month 3HP and/or Leases (car/s, furniture, etc.)Month 1Month 2Month 3Credit Card/sMonth 1Month 2Month 3Loan/sMonth 1Month 2Month 3Cell / Telephone / InternetMonth 1Month 2Month 3DSTVMonth 1Month 2Month 3SecurityMonth 1Month 2Month 3GarnisheeMonth 1Month 2Month 3Other:SpecifyMonth 1Month 2Month 3Excess / ShortfallMonth 1Month 2Month 3 Documentation Upload and ConsentCertified copy of ID Drop files here or Select files Max. file size: 64 MB. Proof of Address Drop files here or Select files Max. file size: 64 MB. Payslips for last 3 months Drop files here or Select files Max. file size: 64 MB. Bank statement for last 3 months Drop files here or Select files Max. file size: 64 MB. Bank confirmation letter (current) Drop files here or Select files Max. file size: 64 MB. Income and expenditure for last 3 months Drop files here or Select files Max. file size: 64 MB. Declaration by Applicant* I, the undersigned, hereby declare that the above information, as supplied by me, is true and correct.
