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Personal details

Title *

Required.

ID number *

Enter a valid 13-digit ID.

First name *

Please enter your first name.

Surname *

Please enter your surname.

Preferred name

Gender *

Required.

Date of birth *

Required.

Number of dependents *

Required.

Education level *

Required.

Marital status *

Required.

Nationality *

Required.

Contact details

Mobile number *

Enter your mobile number.

Work telephone

Email address *

Enter a valid email address.

Years at current address *

Required.

Residential address *

Required.

Employment details

Employer name *

Required.

Employee / staff / Persal number *

Required.

Employer industry *

Required.

Occupation level *

Required.

Occupation status *

Required.

Employment start date *

Required.

Years of service *

Required.

Salary payment method *

Required.

Salary frequency *

Required.

Salary pay day *

Required.

Employer physical address *

Required.

Credit details

Are you a first-time or existing Rofarana client? *

Required.

Have you ever been, are you currently or are you planning to enter Debt Review? *

Required.

Have you ever been, are you currently or are you planning to enter Administration? *

Required.

Have you ever been, are you currently or are you planning to enter Sequestration? *

Required.

Monthly income (R) *

Required.

Tax deduction (R)

UIF (R)

Other salary deductions (R)

Other source of income (R)

Upload proof of other income

PDF, JPG or PNG up to 10 MB.

Loan product *

Please select a product.

Loan amount required (R) *

Enter an amount within your limit.

First-time applicants qualify for up to R1 000. Existing clients qualify for up to R3 000.

Preferred repayment period *

Required.

First-time applicants may choose 1 – 2 months. Existing clients may choose 1 – 6 months.

Reason for loan

Monthly expenses

Please give your best estimate for each item. Your total is calculated automatically.

Rent / bond (R) *

Required.

Car (R)

Water & electricity (R)

Transport (R)

Food & groceries (R) *

Required.

Cellphone & internet (R)

Loans / store accounts / credit cards (R)

School fees / family support (R)

Savings / stokvel (R)

Other regular expenses (R)

Total monthly expenses: R0.00

Banking details

Bank name *

Required.

Account type *

Required.

Account number *

Required.

Branch code *

Required.

Next of kin

Name *

Required.

Surname *

Required.

Relationship *

Required.

Contact number *

Required.

Referral

Name of the person who referred you

Supporting documents

Accepted formats: PDF, JPG, JPEG or PNG. Maximum 10 MB per file. Your documents are uploaded securely and are never publicly accessible.

Latest 3 months bank statement *

Please attach your bank statements.

Latest 3 months payslips / proof of income *

Please attach your payslips.

Proof of address (not older than 3 months) *

Please attach proof of address.

Certified copy of ID *

Please attach a certified copy of your ID.

Picture / selfie *

Please attach a clear picture of yourself.

Client declaration & consent

I declare that all the information given in this application, and in any document submitted with it, is true, complete and correct. I understand that providing false or misleading information may result in my application being declined and may constitute fraud.

I confirm that I am 18 years or older, that I am not currently under debt review, administration or sequestration except as disclosed above, and that I have not applied for or been placed under any such process except as disclosed above.

I consent to Rofarana Cash Loans processing my personal information, including special personal information, for the purposes of assessing this application, verifying my identity, performing affordability assessments, credit checks and fraud prevention, and administering any credit agreement that may follow. This consent is given in terms of the Protection of Personal Information Act, 4 of 2013 (POPIA).

I authorise Rofarana Cash Loans to obtain and share information about my credit record and payment behaviour with registered credit bureaux, the National Credit Register and other credit providers, and to verify my employment, income and banking details with my employer and my bank.

I understand that this application does not constitute an offer of credit, that credit is granted at the sole discretion of Rofarana Cash Loans subject to a successful affordability assessment in terms of the National Credit Act, 34 of 2005, and that all costs, fees and interest will be disclosed to me in a pre-agreement quotation before any agreement is concluded.

I consent to being contacted by telephone, SMS, WhatsApp or email regarding this application and my account, and I confirm that the electronic signature applied below is my own and has the same legal effect as a handwritten signature in terms of the Electronic Communications and Transactions Act, 25 of 2002.

Electronic signature *

Sign using your finger, mouse, stylus or touch screen.

Please sign above.

Review and submit

Please check your details before submitting. Sensitive fields such as your ID number and account number are masked for your safety.

Once submitted, we will begin reviewing your application immediately and come back to you with the outcome.

Personal details

Contact details

Employment details

Credit details

Monthly expenses

Banking details

Next of kin

Referral

Supporting documents

Client declaration & consent

Electronic signature *

Review and submit

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