Signio.lightstoneauto.co.za
Application Requirements
Dear Prospective Signio Clients, kindly take note of the following requirements when submitting an application to Signio:
Mandatory Requirements:
1. The Signio Application Form must be completed in full.
2. Each page of the application form must be initialed by the applicant as well as a witness.
3. Each Signio Application Form must be signed in the appropriate spaces by the applicant as well as a witness.
4. Each Signio Application Form must be accompanied by a signed letter from the Dealer Principle stating that Signio is the preferred vendor, and that Signio may activate the applicable bank dealer codes.
Please complete the forms in accordance with the requirements above, in order to avoid delays in processing your application.
Company Information
|Dealer Name | |
| | |
|Company Reg No | |
|VAT No | |
|FSP No | |
|Physical Address | |
|Postal Address | |
|Tel No | |
|Fax no | |
Dealer Principle Information
(Please attach a copy of ID)
|DP Name and Surname | |
|DP Email Address | |
|DP Contact No | |
|DP Signio Access Y/N | |
Finance and Insurance Manager Information
(Please attach a copy of ID and NCA card)
|F&I Name and Surname | |
|F&I Email Address | |
|F&I Contact No | |
Finance and Insurance Manager Information
(Please attach a copy of ID and NCA card)
|F&I Name and Surname | |
|F&I Email Address | |
|F&I Contact No | |
Finance and Insurance Manager Information
(Please attach a copy of ID and NCA card)
|F&I Name and Surname | |
|F&I Email Address | |
|F&I Contact No | |
Finance and Insurance Manager Information
(Please attach a copy of ID and NCA card)
|F&I Name and Surname | |
|F&I Email Address | |
|F&I Contact No | |
Dealer Codes
Please provide a confirmation letter from the DP that the dealer codes can be activated on Signio
**Please specify if there’s more than one dealer code per bank**
| |Dealer Code 1 |Dealer Code 2 |Dealer Code 3 |
|Absa | | | |
|Wesbank | | | |
|Standard bank | | | |
|MFC | | | |
|African Bank | | | |
|SA taxi | | | |
|Alphera finance | | | |
|Capitec | | | |
Compliance Officer & Key Representative
|Compliance Officer | | |
| |Name and Surname | |
| |Telephone Number | |
| |Fax Number | |
| |E-mail Address | |
|Key Representative | | |
| |Name and Surname | |
| |Telephone Number | |
| |Fax Number | |
| |E-mail Address | |
IGF Requirements
(Please select one of the options below)
| |Please mark with X |
|Both Professional Indemnity and Fidelity Guarantee | |
|Only Professional Indemnity And No Fidelity Guarantee | |
|No Professional Indemnity and Only Fidelity Guarantee | |
|No Professional Indemnity and No Fidelity Guarantee | |
Value Added Products and Insurance
|Supplier Name |Product Name |
| | |
| | |
| | |
| | |
Insurance Supplier
| | |
| | |
| | |
| | |
Applicant Signature
Name:
Surname:
Signature:
Witness Signature
Name:
Surname:
Signature:
Signio (Pty) Ltd | Registration Number 2003/001508/07
T: +27 (0)12 684 6600 | F: +27 (0)12 684 6629
Southdowns Office Park, Block B 2nd Floor, Cnr John Vorster Drive & Karee Street, Highveld, Centurion
Directors: A E J Pentz, A H Miller, J G Williams
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