Fillable Customer Credit Application Form

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Customer Credit Application Form

On average this form takes 10 minutes to complete

The Customer Credit Application Form form is 2 pages long and contains:

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  • 10 check-boxes
  • 35 other fields

Country of origin: OTHERS
File type: PDF

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Customer Credit Application Form
First Name _________________________________________ Last Name __________________________________________
Sex _________________________________________________ Date of Birth ________________________________________
Marital Status ______________________________________ No. of Dependents __________________________________
CLIENT DETAILS
Unit/Lot Number ____________ Section Number ______________ Suburb ____________________________________
Street _______________________ Province_______________________ Village/Town/City ___________________________
Phone ______________________ Mobile ________________________ Email Address ______________________________
Postal Address ____________________________________________________________________________________________
CONTACT DETAILS
Employer Name ____________________________________ Date of Employment ________________________________
Title/Position ________________________________________ Department ________________________________________
Office Phone _______________________________________ Email Address_______________________________________
Address of Employer ______________________________________________________________________________________
Staff ID/Payroll ______________________________________ Name of Paymaster _________________________________
EMPLOYMENT DETAILS
Please attach the following documents into one zipped file and name the zipped file with client first
name initial and last name e.g. jblow.zip Note: Maximum file size is 5MB
1. Three (3) latest payslips
2. Copy of Identification e.g. Current employment ID, PNG Drivers License, Passport, etc.
3. Confirmation of Employment Letter outline: Date of employment, Current Position Held,
Remuneration, Value of Long Service Leave (LSL) Entitlements.
Bank Institution _____________________________________Branch _____________________________________________
Account Type _________________ Account Name _______________________ Account Number ___________________
BANK DETAILS
Purpose of Loan __________________________________________________________________________________________
Invoice Number _____________________________________ Amount Applied For _______________________________
Loan Repayment Amount ___________________________ Loan Term (No. Of Payments) _______________________
LOAN DETAILS
CONTACT OUR CUSTOMER CREDIT TEAM TODAY
CALL 325 5411 OR EMAIL CCS@BRIANBELL.COM.PG
LOAN FUNDED BY
FINANCE CORPORATION LTD
BUY NOW. PAY LATER
CUSTOMER CREDIT
BRIAN BELL
facebook.com/brianbellgroup homecentres.brianbell.com.pg
PREREQUISITES
1. Applicant’s Employer must be registered with Customer Credit Service (CCS). Refer CCS staff
for confirmation.
2. Applicant must be employed a minimum of three (3) years with the same organisation.
3. Employment status is Permanent. Part-time/casual employees are ineligible.
Once prerequisites are satisfied, Applicant can proceed with providing necessary requirements.
REQUIREMENTS
1. Three (3) latest payslips.
2. Minimum two (2) forms of identification (eg. current employment ID, PNG drivers license, passport).
3. Confirmation of Employment Letter outlining:
• Date of Employment
• Current Position Held
• Remuneration
• Value of Long Service Leave (LSL) Entitlements
4. Quote from Brian Bell or any partner organisation such as ‘Keynote Music House’. Enquire in-store for
other partner organisations.
Quotes are obtained from any Brian Bell Customer Service Desk and directly from any partner
organisation. ALL QUOTES ARE VALID FOR 14 DAYS ONLY
CUSTOMER CREDIT OPTION POLICY
• No deposit required.
• Minimum accumulated purchase value is K200 and can comprise of any items from Brian Bell or partner
organisations.
• Maximum purchase value is determined by Applicant’s eligibility.
• Minimum repayment term is five (5) fortnights or ten (10) weeks.
• Maximum repayment is 52 fortnights or 24 months.
• Applicant’s CCS purchase value (including term changes) must not exceed 50% of Applicant’s LSL entitlements.
• First deduction must commence before items are collected/delivered (cash payment in lieu of first deduction
is not permitted).
• Applicant must provide evidence of first deduction i.e. payslip prior to collection/delivery of items.
SEE SALARY DEDUCTION FORM FOR TERMS & CONDITIONS.
Customer Credit Information
CONTACT OUR CUSTOMER CREDIT TEAM TODAY
CALL 325 5411 OR EMAIL CCS@BRIANBELL.COM.PG
LOAN FUNDED BY
FINANCE CORPORATION LTD
BUY NOW. PAY LATER
CUSTOMER CREDIT
BRIAN BELL
facebook.com/brianbellgroup homecentres.brianbell.com.pg
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Customer Credit Application Form

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Completed 28 October 2020

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