Email Us - Cars for Blacklisted

Do you live in...?*

Gauteng
Limpopo
North West
Mpumalanga
Other

Question 1 of 5

Do you have a valid driver’s license?*

Yes
No

Question 2 of 5

Do you have a criminal record?*

No
Yes

Question 3 of 5

Do you have a once off Admin Fee of…*

R10 000
R12 500
R14 500
More than R14 500

Question 4 of 5

What can you afford monthly for a vehicle (your budget)? This is including insurance.*

Between R 2 500 – R 3 500
Between R 3 500 – R 4 000
Between R 4 000 – R 6 000
More than R 6 000

Question 5 of 5

Do you have a valid ID or proof thereof?*

Yes
No

Thank you for completing the form.

Please complete your personal details below and submit the form.
We will contact you or call us on 080 327 6222 after submitting the form.

Congratulations. You’ve been approved.

Please complete your personal details below and submit the form.
We will contact you to book an appointment or call us on 080 327 6222 after submitting the form.

Your Information

Name*

Email*

Telephone Number*

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Please confirm your contact number

When is the best time to contact you telephonically?*