Loan Against Property / Equity Release R5 million to R50 million

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NOTE: This form refers ONLY to the above product solution:

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Surname:*

First Name:*

Lead Provider No. (if applicable):

Legal Entity Name (if applicable):

Cell No:*

Alternative No:

Email:*

City or Town:*

Province:*

Type of Property:

(A) Market Value of Property:*

(B) Outstanding Bond Amount:*

Is your un-bonded property a legal entity name ( Company, CC , Trust)?*

Yes
No

Is the un-bonded property your primary residence?*

Yes
No

From what funds will the Bridging Loan be repaid ?:*

Bridging Amount Required:*

Lead Provider Name:

Lead Provider Business Name:

Lead Provider Number:

Where did you hear about us?:*

Internet search
Referred by friend
Internet advert
Newspaper advert
Magazine advert

By submitting this form, I acknowledge and accept that this enquiry is submitted to the owners of this website and to third party/s, to whom I give permission to contact me to try and assist and that I understand that there is NO GUARANTEE that a loan will be approved or granted; nor attended to within a specific time period.

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