Online Debt Review Application

Complete this free application and a Fin Rescue debt counsellor will assess your situation. It takes about 15 minutes.

Your information is sent securely and is treated with the utmost confidentiality. Have your ID, latest payslip and creditor details ready. Fields marked * are required.

Step 1 of 5: Personal Details

Main Applicant

First Name

Last Name

ID Number

Your 13-digit South African ID number (or passport number).

Email Address

Mobile Number

Home Number

Gender

Male

Female

Marital Status

Language Preference

Dependants

Number of Dependants

Ages of Dependants

For example: 4, 9, 15

Where do your school-going children stay after school?

Physical Address

Street Address

City / Town

Province

Postal Code

Postal Address

City / Town

Province

Postal Code

Cancel Application

Step 2 of 5: Employment & Spouse

Main Applicant – Employment

Employer Name

Job Title

Work Number

Employer Address

City / Town

Province

Postal Code

Spouse Details

Compulsory if you are married in community of property (COP) or by African traditional marriage.

Spouse First Name

Spouse Last Name

Spouse ID Number

Spouse Email Address

Spouse Mobile Number

Spouse Employer Name

Spouse Work Number

Spouse Employer Address

City / Town

Province

Postal Code

Step 3 of 5: Monthly Budget

Income

Income item	Main Applicant	Spouse
Gross Income	R	R
Commission	R	R
Overtime	R	R
Rental Income	R	R
Child Maintenance Income	R	R
Total Income (calculated)	R	R

Salary Deductions

Salary Deductions item	Main Applicant	Spouse
PAYE	R	R
UIF	R	R
Pension / Provident Fund	R	R
Medical Aid	R	R
Garnishee Orders	R	R
Staff Loans	R	R
Other Deductions	R	R
Total Deductions (calculated)	R	R

Living Expenses

Living Expenses item	Main Applicant	Spouse
Food / Groceries / Clothing	R	R
Property Rental	R	R
Water / Electricity / Rates / Levies	R	R
Security	R	R
School Fees	R	R
Short-Term Insurance	R	R
Vehicle Insurance	R	R
Life Insurance	R	R
Fuel / Transport	R	R
Child Maintenance	R	R
Medical Costs	R	R
Telephone & Internet	R	R
Other Expenses	R	R
Total Expenses (calculated)	R	R
Amount Available for Debt Review	R	R

Married Out of Community of Property (ANC) – Single Application

Only complete this if you are married out of community of property and applying on your own.

Is your spouse employed?

If employed, how much does your spouse contribute to the monthly expenses? (R)

Step 4 of 5: Debts & History

Creditor Obligations

List all your credit agreements, including bank overdrafts. Put each creditor on a new line in the same order in every box.

Creditor & Account Type

e.g. ABC Bank – Credit Card

Account Number

Outstanding Balance (R)

Current Monthly Instalment (R)

Previous Debt Review Information

Have you previously been under debt review?

Was a court order granted?

If yes, details of the previous debt counsellor

Reason for leaving the previous debt counsellor

Reason for Over-Indebtedness

Please give a short description of why you became over-indebted

Step 5 of 5: Documents & Declaration

Supporting documents

PDF, JPG, PNG, HEIC or WEBP. Maximum 10 MB per file and 3 files per document.

Main Applicant – Copy of ID

Main Applicant – Latest Payslip

Spouse – Copy of ID (if married in community of property)

Spouse – Latest Payslip (if applicable)

Signatures

Main Applicant Signature

Sign with your finger or mouse.

Spouse Signature (if applicable)

Sign with your finger or mouse.

Declaration

I hereby declare that the information supplied by myself in the application form is for myself and is true and correct, and includes all my credit agreements. I consent to Fin Rescue obtaining my credit report from a registered credit bureau for the purpose of obtaining my credit agreements to assist in the assessment.

By submitting this application you also accept our Terms and Conditions.

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