FINANCE LINKED INDIVIDUAL SUBSIDY …

1 In the Application form PD means the Provincial Department responsible for Human Settlements; and NHFC refers to the National Housing FINANCE Corporation , which is acting as the Implementing Agent on behalf of the relevant Provincial Department for the administration of flisp in the Province. For office use only * Tick ( ) whichever is applicable. INDIVIDUAL Registration No. INDIVIDUAL PHDB Resolution No. The application is hereby declined for the following reasons: 1. 2. 3. 4. In case of incomplete information, contact: [to be completed by applicant] Full Names: Postal Address: Postal Code: Telephone Home: [code: ] Work: [code: ] Cell-phone: [code: ] Fax: [code: ] Email address: FINANCE LINKED INDIVIDUAL SUBSIDY PROGRAMME F L I S P A P P L I C A T I O N F O R M P a g e | 2 flisp | APPLICATION form TABLE 1 The following documents must be kept by the NHFC/PD (confirm receipt thereof by inserting a or in the applicable box) Applicant Spouse Official use only 1.

2 Certified copy of Marriage Certificate, Civil Union Certificate or Co-habiting Affidavit 2. Certified copy of Bar Coded Identity Document 3. Certified copy of Birth Certificate bearing the 13-digit Identity Document number 4. Certified copy of Divorce Settlement 5. Certified copy of Bar Coded Identity Documents of all persons claimed as part of the household 6. Certified copy of Spouse s Death Certificate 7. Certified copy of Permanent Residence Permit (Bar Coded Permit) 8. Proof of in principle letter of grant issued by lender in respect of the loan, where applicable 9. Certified copy of Agreement of Sale; if applicable 10.

3 Certified copy of Building Contract and Approved Building Plan, if applicable 11. Certified copy of Proof of Monthly Income TABLE 2 (for NHFC use only) PROCESS RECORD DATE SIGNATURE Official Supervisor 1. Application Received 2. Electronic Procedural Check 3. Application Returned for Correction from PD 4. Application Returned Corrected 5. Data Captured 6. Data Verified 7. Searches Completed: a) Home Affairs b) Deeds Office c) National Housing Database Programme 8. Date SUBSIDY Approved by PD 9. Date Applicant notified of PD s decision P a g e | 3 flisp | APPLICATION form SECTION A: PERSONAL DETAILS: (To be completed by all Applicants) A Spouse is defined as a Husband, Wife or Long Term Partner co-habiting with the Applicant for a period of at least 6 months in succession at the time of application.

4 Marital Status: Period Marital Status Period Married* Habitually Co-habiting with long term partner* Divorced with dependants* Divorced without dependants* Single with dependants* Single without dependants* Widow/Widower with dependants* Widow/Widower without dependants* DETAILS OF THE APPLICANT(S) SPOUSE (or Deceased Partner) Surname: Maiden / Former Surname: Full Names (first3 only): Gender*: Male Female Male Female Race*: If other specify: African* White* African* White* Coloured* Indian* Coloured* Indian* Other* Other* RSA Identity Document no.: Residential Address: Postal Code: *For Statistical Purposes SECTION B: DETAILS OF ALL DEPENDANTS Surname Initials ID / 13-digit Digit Birth Certificate No.

5 Age Relationship to Applicant Gender F M F M F M F M F M F M P a g e | 4 flisp | APPLICATION form SECTION C: MONTHLY INCOME DETAILS (to be completed by Applicant) Applicant Spouse [if * Y, insert details, Name of Employer if Employed, type of Social Grant, etc.] Indicate if you are: Employed * Y N Self Employed * Y N Social Welfare * Y N Basic Monthly Income: R R Housing Allowance Payable (Loan Interest SUBSIDY ): R R Social Welfare Grant: R R TOTAL: R R JOINT TOTAL (Applicant and Spouse) R Amount of Bond Applied for R SECTION D: DETAILS OF CITIZENSHIP (To be completed by Applicant) Are you a South African Citizen YES * NO * If you are not a South African Citizen supply the following: Country of which you are a Citizen South African Permanent Residence Permit Number Date Permit was Issued SECTION E.

6 DETAILS OF PROPERTY TO BE PURCHASED WITH SUBSIDY (To be completed by Applicant) Name of Seller: District: Municipality: Township: Erf (Stand) / Lot Number*: Township Extension: Unit Number: Description of Dwelling * Flat (Name of Building) House (Street Address) Type of Tenure* Ownership Other, specify: P a g e | 5 flisp | APPLICATION form SECTION F (i): FUNDING DETAILS IN RESPECT OF PURCHASE OF PROPERTY (To be completed by Applicant) TOTAL PRODUCT PRICE R a) SUBSIDY R b) Amount of Home Loan R c) Own Cash Contribution (if any) R TOTAL R d) SUBSIDY amount qualified for R e) Total Bond qualified for R f) Disability SUBSIDY (Plus) R g) Geotechnical Assistance (Plus) R Sub Total: R h) Grants Received from State Resources (Minus) R Total SUBSIDY Amount Qualified for: R SECTION G: DETAILS OF CONVEYANCER (to be completed by the NHFC) Name: Postal Address: Postal code: Conveyancer Fee: R Approval Code of Lender: Telephone no.

7 : [code: ] Fax no.: [code: ] Email address: SECTION H: DETAILS OF LENDER FOR A flisp APPLICATION (to be completed by NHFC) Name: Postal Address: Postal code: Approval Code of Lender: Telephone no.: [code: ] Fax no.: [code: ] Email address: P a g e | 6 flisp | APPLICATION form SECTION I: DETAILS OF CONTRACTOR/BUILDER (to be completed by Contractor/Builder) Name: Postal Address: Postal code: NHBRC Registration no.: Telephone no.: [code: ] Fax no.: [code: ] Email address: flisp CONDITIONS OF SUBSIDY : I, _____ the Applicant hereby acknowledge that the granting of the flisp SUBSIDY is subject to the following terms and conditions, which I consider binding on me for a period commencing on the date on which payment of the flisp SUBSIDY is made out into the transferring attorney s trust account to the 8th (eighth) anniversary of such date ("claw-back period') : 1.

8 That all the Qualification Criteria are true and correct and that I have not either negligently or fraudulently misrepresented any information pertaining to myself or any other party on whose behalf I make representations in this application form ; 2. the flisp SUBSIDY is a once-off amount that must be used to reduce the principal Loan amount to render the Loan repayment installments affordable or to make good any shortfall between the qualifying Loan amount and the purchase price of the Unit, provided that the purchase price of a Unit may not exceed R300 000 (three hundred thousand rand) inclusive of value added tax (VAT) for the 2012/13 finacial year and shall not be used to increase the principal loan amount or to FINANCE the costs attached to the transfer or the property or the registration of the mortgage bond; 3.

9 The Provincial Department or it s agent the National Housing FINANCE Corporation has endorsed the title deed of the property to which this flisp SUBSIDY relates such in the event that I should elect to sell the property which is the subject of the flisp SUBSIDY within the claw-back period, the Provincial Department shall have a right to recover from me an amount reflected in the table below depending on the year in which I propose to sell the property; Year 1: 90% of the original SUBSIDY amount is to be refunded; Year 2: 80% of the original SUBSIDY amount is to be refunded; Year 3: 70% of the original SUBSIDY amount is to be refunded; Year 4: 60% of the original SUBSIDY amount is to be refunded; Year 5: 50% of the original SUBSIDY amount is to be refunded Year 6: 40% of the original SUBSIDY amount is to be refunded; Year 7: 30% of the original SUBSIDY amount is to be refunded; and Year 8: 20% of the original SUBSIDY amount is to be refunded.

10 4. in the event that I should default on any of the payments due to the lender under the loan agreements resulting in the lender recovering any outstanding amounts from me, that :- a. where the lender sells the property to satisfy its outstanding debt under the loan agreement, and b. where the lender, having so sold the property, recovers an amount in excess of the outstanding debt ('recovered amount") I hereby waive all my rights under any agreements with any creditors (other than the Provincial Department) and in law to receive that part of the recovered amount which has become due and payable to the Provincial Department in terms of the table below.