Please choose one of the following

Please answer all questions below.

Business Details

Contact/Address Details

Name of Directors of Company/Members of the Corporation

Trade References

Does the Company have any pending litigation against it? If yes please provide more information.

Has the Company applied for Business Rescue in the last 6 months? If yes, please provide more info.

Is the Company under Business Rescue or intend undergoing Business Rescue in the next 3 months?

When is the Company's financial year end?

What was the Company's previous Annual Turnover?

What is the Company's current Year to Date Turnover?

What are the Company's current loans and with who?

Total number of employees?

Will this funding help sustain these jobs?

Will this funding help create more jobs? If so, How many?

What level of BB-EEE ownership does the company have?

What level BB-EEE contributor is your company?

Have you approached a bank for this funding? If Yes, what was their response? If not, Why?

Is the Company's debtors book held as security/factored?

Is the company standing surety for anything else?

How did you hear of ProfitShare Partners?

Are you or any of the Directors a USA citizen / USA Tax Payer?

Do you receive/have any income or dealings with the U.S.A?

1.We only transact with Juristic entities, not Sole Proprietors and / informal Partnerships;

2.All information supplied by You to Us is true and correct;

3.We rely materially on the accuracy of such information and the said information to determine whether or not to transact with you;

4.We are not a Financial Institution, Bank, Credit Provider or Financial Services Provider;

5.We do not loan monies or provide you with Credit;

6.Any transaction which may be entered into between you and us is not subject to the Terms of the National Credit Act or Consumer Protection Act and you shall not be entitled to avail yourself to any of the Provisions thereof; and

7.Should your Application be successful and we furnish you with a quote, you cannot infer or represent that such Quotation is an Endorsement of the merits of merits of your entity, business or any particular proposed transaction. We access transaction on a risk / reward time frame ratio and also factor in our exposure on other transactions unrelated to you or yours and the spread of our exposure;

8.Our Response to this Application does not oblige us to enter into any transactions with yourselves;

9.In the event of Us Entering into a Transaction with You We shall require persons in Control of the Applicant to Sign Personal Surety in addition to any other Security;

10.Should your Application be unsuccessful, this does not mean we are unwilling to transact with You, it means we are unwilling to transact on the particular transaction you proposed, feel free to Apply to us on other qualifying transactions

11.By submitting this Application, you confirm that you have familiarised yourself with the nature of our Business and our Standard Terms and Conditions, Requirements, Restrictions and the like.

12.By submitting this application, you hereby declare that you are duly authorised to transact/act on behalf of the company and all information provided by yourself is true and correct.

13.You authorise ProfitShare Partners (Pty) Ltd to conduct any credit checks on the company and its directors.

14.You authorise ProfitShare Partners (Pty) Ltd to verify all information provided by You..

15.You permit ProfitShare Partners (Pty) Ltd to contact Your suppliers and Your customers..

16.If You were referred by a Lead Provider, You authorise ProfitShare Partners (Pty) Ltd to share your application status to the said Lead Provider.