Credit Provider Additional Information Form

Applicant Type

(for Office Use)

Member Size

Choose the bracket representing how big your total outstanding debtors book is.

Member Type

Credit Product Channel

FIC Status

FIC Number

Mandatory if "Registered" was chosen for FIC Status.

Sign the Code of Conduct * Open & Sign Document

Sign Debit Order Mandate Open & Sign Document

CIPC Document *

NCR Certificate

Mandatory if "Registered" was chosen for FIC Status.

FIC RMCP

Mandatory if "Registered" was chosen for FIC Status.