CDI Capital – Loans – CDI Capital

Loan Application

"*" indicates required fields

You can save your work at any stage, go to the bottom of the page and click save. Look out for guidelines below the answer field of the question.

Business Profile

Business Name*

Business Registration Number*

Registration Date*

Tax Reference Number*

Business Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Premises*

Owned

Rented

Industry Sector*

Product Description*

(max 250 characters)

Website*

Please type - http://www. and then the rest of your web address. If you don't have a website, please type - http://www.cdicapital.co.za

Trading History

How many years have you been in business?*

Trade Reference 1 - Name of Company

Monthly Spend*

Contact Person*

First Last

Contact Number:*

Trade Reference 2 - Name of Company

Monthly Spend*

Contact Person*

First Last

Contact Number:*

Trade Reference 3 - Name of Company

Monthly Spend*

Contact Person*

First Last

Contact Number:*

Judgements against the business*

Yes

Is the company under Business Rescue or intend entering Business Rescue proceedings in the next 6 months?*

Yes

Directors/Members/Shareholders/Owners

How many owners are there in your business?*

Owner 1

Owner 1*

First Last

Identity Number:*

Percentage ownership*

Length of ownership*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home*

Owned

Rented

Contact Number:*

Email*

Owner 2

Owner 2*

First Last

Identity Number:*

Percentage ownership*

Length of ownership*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home*

Owned

Rented

Contact Number:*

Email*

Owner 3

Owner 3*

First Last

Identity Number:*

Percentage ownership*

Length of ownership*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home*

Owned

Rented

Contact Number:*

Email*

Owner 4

Owner 4*

First Last

Identity Number:*

Percentage ownership*

Length of ownership*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home*

Owned

Rented

Contact Number:*

Email*

Owner 5

Owner 5*

First Last

Identity Number:*

Percentage ownership*

Length of ownership*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home*

Owned

Rented

Contact Number:*

Email*

Additional owner information

Any owners declared bankrupt, insolvent or under debt review*

Yes

Have you participated in a CDI programme, if so, please name the programme and your contact person at the CDI

First Last

Finances

Annual Turnover ZAR*

Annual Gross Profit ZAR*

Annual Operating Costs ZAR*

Annual Net Profit ZAR*

Loan Required ZAR*

Purpose of the loan*

max 500 characters

If you have a Purchase Order, what is the value ZAR*

Please enter a number from 0 to 2000000.

What is the value of your current loans ZAR*

Please enter a number from 0 to 5000000.