First Name :

Surname :

ID Number/Passport No:

Nationality :

Cell/ Tel No :

Alternative Phone Number:

Email Address :

Current Home Address :
Door Number and Apartment/Complex Name:

Street Number and Street Name :

Suburb:

City:

Postal Code :

Province:

Country:

Your Gross Income(Before Deductions)/Drawings if you a business owner:

Your Net Income(Income after Deductions:

RENT APPLICATION
Name of Building/Apartment/Complex name:
City and Surburb you wish to live in:

Type of Unit
Bachelor1 Bed Room2 Bed Room3 Bed RoomOther

BANKING DETAILS OF APPLICANT

Account Holders name:
Name of Bank:
Branch Name or Town where Account Opened:
Branch Code:
Account Type: Eg Savings/ Cheque/Current:

RESIDENCY HISTORY

Current Residential Address
Apartment Name and Door Number:
Street Number and Street Name:
Surburb:
City:
Province:
Rent Paid at this Address:
Period you lived here:

PREVIOUS RESIDENCE-Must Supply this info- If not Applicable indicate with a "N/A":
Street Address:
City:

Province:
Period you Lived Here:

EMPLOYMENT-CURRENT/Business Owners must also provide details of their company here
Company Name :
Address of Employer:
Employer Phone Number:
Occupation:
Name of Supervisor/manager:

NEXT OF KIN (Can be Brother, Sister, Parent etc but Not Living with You
Name and Surname:
Address:
City and Province :
Contact Number:
ID Number:
Relationship:

List of All occupants:
Occupant 1:
Occupant 2:
Occupant 3:
Occupant 4:
Please leave this field empty.
LEASE PERIOD
Start Date:
End Date:
Permanent Current Vehicle
Make:
Model eg M3/ I3/ T-roc etc:
Use your finger to sign directly on your mobile screen: