Step 1

Spouse Details

Budget Details

Creditor Obligations

(please include bank overdrafts)

Debt Review & Declaration

  • Your Details
  • Spouse Details
  • Budget Details
  • Creditor Obligations
  • Declaration

Your Personal Details

First Name

Last Name

ID Number

Email

Mobile

Telephone

Gender

Ethnic Group

*This information is only used for statistical purposes.

Marital Status

Language Preference

Number of Dependants

Ages of Dependants

Where do your school-going children stay after school?

Physical Address

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal Code

Employer

Spouse Details

First Name

Last Name

Spouse ID Number

Spouse Mobile

Spouse Work Number

Spouse Employer Name

Spouse Employer Address

Address Line 1

Address Line 2

City

State / Province

ZIP / Postal Code

Budget Details

Income

Gross Income - Main Applicant

Commission - Main Applicant

Overtime - Main Applicant

Rental Income - Main Applicant

Child Maintenance Income - Main Applicant

Total Income - Main Applicant

Gross Income - Spouse

Commission - Spouse

Overtime - Spouse

Rental Income - Spouse

Child Maintenance Income - Spouse

Total Income - Spouse

Salary Deductions

PAYE - Main Applicant

UIF - Main Applicant

Pension/Provident Fund - Main Applicant

Medical Aid - Main Applicant

Garnishee Orders - Main Applicant

Staff Loans - Main Applicant

Other - Main Applicant

Total Deductions - Main Applicant

Nett Salary - Main Applicant

PAYE - Spouse

UIF - Spouse

Pension/Provident Fund - Spouse

Medical Aid - Spouse

Garnishee Orders - Spouse

Staff Loans - Spouse

Other - Spouse

Total Deductions - Spouse

Nett Salary - Spouse

Living Expenses

Food / Groceries / Clothing - Main Applicant

Property Rental - Main Applicant

Water / Electricity / Rates / Levies - Main Applicant

Security - Main Applicant

School Fees - Main Applicant

Short Term Insurance - Main Applicant

Vehicle Insurance - Main Applicant

Life Insurance - Main Applicant

Fuel/Transport - Main Applicant

Child Maintenance - Main Applicant

Medical Costs - Main Applicant

Telephone & Internet - Main Applicant

Total Expenses - Main Applicant

Amount Available For Debt Review - Main Applicant

Food / Groceries / Clothing - Spouse

Property Rental - Spouse

Water / Electricity / Rates / Levies - Spouse

Security - Spouse

School Fees - Spouse

Short Term Insurance - Spouse

Vehicle Insurance - Spouse

Life Insurance - Spouse

Fuel/Transport - Spouse

Child Maintenance - Spouse

Medical Costs - Spouse

Telephone & Internet - Spouse

Total Expenses - Spouse

Amount Available For Debt Review - Spouse

If Married

Out of Community of Property (Antenuptial Contract) and Single Application, please complete the following:

Is your spouse employed?

If employed, what amount does your spouse contribute to the monthly expenses?

Creditor 1

Creditor #1 & Account Type

Account Number #1

Outstanding Balance #1

Current Instalment #1

Creditor 2

Creditor #2 & Account Type

Account Number #2

Outstanding Balance #2

Current Instalment #2

Creditor 3

Creditor #3 & Account Type

Account Number #3

Outstanding Balance #3

Current Instalment #3

Creditor 4

Creditor #4 & Account Type

Account Number #4

Outstanding Balance #4

Current Instalment #4

Creditor 5

Creditor #5 & Account Type

Account Number #5

Outstanding Balance #5

Current Instalment #5

Debt Review

Have you previously been under debt review?

If yes, please give details of the previous debt counsellor

Reason for leaving previous debt counsellor

Was a court order granted?

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 Debt Blasters obtaining my credit report from a registered credit bureau for the purpose of obtaining my credit agreements to assist in the assessment.

Please supply us with the following documents:

Copy of ID - Main Applicant

Max. size: 32.0 MB

Copy of latest Payslip

Max. size: 32.0 MB

Copy of ID - Spouse (If Married in Community of Property)

Max. size: 32.0 MB

Copy of latest Payslip - Spouse (If Applicable)

Max. size: 32.0 MB

Got Questions?

WE HAVE THE ANSWERS

Yes! We can help anybody in South Africa, no matter where you live. Our process is extremely confidential and most of the communication between us will be electronic. We also have a national network of lawyers than can represent you anywhere in South Africa if that is required.

Yes! Once your debt review is complete, we issue you a clearance certificate. Your credit profile is now squeaky clean and you are free to access credit from responsible lenders.

The fees are completely regulated and will be explained to you in detail during your consultation.

It may happen that they contact you but they are legally bound to the court order and can not institute any legal action or any further collections actions. If this happens you refer them straight to Debt Blasters, we will deal with them.


Business Hours

Monday to Friday:
08h00 – 17h00