Credit Application Form|South African Conversations

Step 1: Company Information

Full trading name*

Full registered name*

Registration Number

VAT Number

Type of entity (Pty Ltd / NPC / NPO / Trust / Partnership)*

Nature of business*

Operational since*

Company director(s) or responsible persons*

Postal address

Physical Address

Address line 1*

Address line 2

Suburb / Township*

Town / City*

Municipality / District (if relevant)

Postal code*

Province*

Telephone*

Email*

Website

Name and designation of person responsible for payments*

Email of the accounts department or the person responsible for payments*

Credit Requested*

Enter the amount of credit you are applying for (e.g., the typical monthly amount you expect to be invoiced). This helps us assess the appropriate credit terms.

Amount*

Is this a monthly or an ad hoc credit requirement (Tick relevant box)*

Monthly

Ad Hoc

Step 2: Banking Details

Bank*

Branch Code*

Account Holder Name*

Account number*

Type of account*

Step 3: Required Uploads
I consent to South African Conversations storing and processing the documents and information submitted for the purpose of assessing this credit application.

Please upload proof of bank account*

Max. file size: 64 MB.

Please upload a copy of business registration document*

Max. file size: 64 MB.

Please upload proof of business physical address*

Max. file size: 64 MB.

This is a FICA requirement.

Step 4: Trade References

Reference 1

Company name*

Company address

Contact name*

Designation*

Contact number*

Account opened since*

Credit limit*

Reference 2

Company name

Company address

Contact name

Designation

Contact number

Account opened since

Credit limit

Reference 3

Company name

Company address

Contact name

Designation

Contact number

Account opened since

Credit limit

Step 5: Terms & Conditions

I declare that the information provided in this application is true, correct and complete. I understand that it will be used by South African Conversations (Pty) Ltd to assess my organisation’s creditworthiness and determine appropriate credit terms. I authorise South African Conversations to contact and obtain information from the trade and banking references listed in this form, and I consent to those institutions releasing such information for the purpose of this credit assessment. I understand that approval of this application is not guaranteed and that South African Conversations may, at its discretion, approve, decline or amend the proposed credit terms. Should this application be unsuccessful, the organisation will be required to complete a Direct Debit Mandate for any contracted amounts payable under the agreement. By submitting this form, I agree that all invoices are payable within the agreed payment terms and that South African Conversations reserves the right to suspend service, charge interest for overdue amounts where applicable, or review and adjust the credit limit at any time based on payment history, risk assessment or changes in trading activity.

I confirm that I have read and agree to the Terms & Conditions stated above.*

I confirm

Privacy Notice

South African Conversations values the privacy and security of your information. We will never sell your personal information and will take every precaution to protect your data.

All information will be processed in accordance with the Protection of Personal Information Act (POPIA).

Step 6: Authorised Signatory

Full name of authorised signatory*

ID number*

Designation*

Cell number*

Email*

Name of organisation on whose behalf I am authorised to sign this application*

Date*