RESIDENTIAL LEASE APPLICATION FORM

1 RESIDENTIAL LEASE APPLICATION form OFFICE USEA. APPLICANT/S DETAILSA pplicant 1: Applicant 2:Title:.. Title:..Surname: .. Surname: ..Initials: .. Initials: ..Full names: .. Full names: ..Gender: Male Female Gender: Male Female ID Type: SA ID Passport ID Type: SA ID Passport ID/Passport number: .. ID/Passport number: ..Country of issue: .. Country of issue: .. Date of birth: .. Date of birth: ..SA citizen: Yes No SA citizen: Yes No If not, permit number.

2 If not, permit number: .. Permit expiry date: .. Permit expiry date: ..Passport expiry date: .. Passport expiry date: ..Country of permanent residence: .. Country of permanent residence: ..Telephone number: .. Telephone number: ..Mobile phone: .. Mobile phone: ..Email address: .. Email address: .. RESIDENTIAL address: .. RESIDENTIAL address: .. Code: .. Code: ..How long have you lived here: .. How long have you lived here: .. address: .. Postal address: .. Code: .. Code: ..email: website: PO Box 15, Pretoria, 0001 City Property Administration (Pty) Ltd. Reg. No. 1968/010808/07 Tenant code:Case number: Q number: Deal maker: Property name: Property code: Bach1 BedUnit Bed2 Bed3 Bed4 BedStatus: New Existing Trf credit: Ye s No If existing: Unit change Building transfer Renewal LEASE fee: Standard Downgrade Upgrade Credit Control: Bursary Student Building Manager 15th payer LEASE start date.

3 LEASE term: ..Tenant type: Natural Juristic BO: Ye s No Deposit: Ye s No Number of months: 1 2 3 Notes: ..Please note that an incomplete form will not be ID: email: website: PO Box 15, Pretoria, 0001 City Property Administration (Pty) Ltd. Reg. No. 1968/010808/07 Complete if applicant is a Company/CC/Trust/NPCE ntity name:.. Registration number:..Trading as: .. VAT number: ..B. APPLICANT/S MONTHLY LIVING EXPENSESA pplicant 1: Applicant 2:Maintenance:.. Maintenance:..Mobile phone: .. Mobile phone: ..Church/donations: .. Church/donations: ..Cigarettes and liquor: .. Cigarettes and liquor: ..Clothing:.. Clothing:..Medical aid (additional): .. Medical aid (additional): ..Doctors and chemists.

4 Doctors and chemists:..Gambling: .. Gambling: ..Groceries:.. Groceries:..Housekeeper: .. Housekeeper: ..Insurance: .. Insurance: ..Internet and telephone: .. Internet and telephone: ..Parking:.. Parking:..Fuel (petrol/diesel): .. Fuel (petrol/diesel): ..Rates, taxes and levies:.. Rates, taxes and levies:..School/university fees: .. School/university fees: ..Security:.. Security:..Spending money: .. Spending money: ..Sports:.. Sports:..Transport (bus/taxi): .. Transport (bus/taxi): ..Water and electricity:.. Water and electricity:..Other: .. Other: ..C. APPLICANT/S MONTHLY FIXED DEBT REPAYMENTSA pplicant 1: Applicant 2:Home loan/rental payment:.. Home loan/rental payment:..Vehicle loan 1 repayment.

5 Vehicle loan 1 repayment: ..Vehicle loan 2 repayment: .. Vehicle loan 2 repayment: ..Overdraft/credit line repayment: .. Overdraft/credit line repayment: ..Term loan repayment:.. Term loan repayment:..Credit card 1 payment: .. Credit card 1 payment: ..Credit card 2 payment: .. Credit card 2 payment: ..Retail account 1 payment: .. Retail account 1 payment: ..Retail account 2 payment: .. Retail account 2 payment: ..Other: .. Other: ..Please note that an incomplete form will not be : website: PO Box 15, Pretoria, 0001 City Property Administration (Pty) Ltd. Reg. No. 1968/010808/07D. APPLICANT/S INCOMEA pplicant 1: Applicant 2:Employment status: Employed Self-employed Employment status: Employed Self-employed Monthly gross salary.

6 Monthly gross salary: ..Monthly net take home pay: .. Monthly net take home pay: ..Do you earn overtime: Yes No Do you earn overtime: Yes No If yes, how regular: .. If yes, how regular: ..Specify gross amount: .. Specify gross amount: ..Do you earn commission: Yes No Do you earn commission: Yes No If yes, how regular: .. If yes, how regular: ..Specify gross amount: .. Specify gross amount: ..Do you earn a social grant: Yes No Do you earn a social grant: Yes No If yes, how regular: .. If yes, how regular: ..Specify gross amount: .. Specify gross amount.

7 Do you earn investment income: Yes No Do you earn investment income: Yes No If yes, how regular: .. If yes, how regular: ..Specify gross amount: .. Specify gross amount: ..Do you earn any other income: Yes No Do you earn any other income: Yes No If yes, how regular: .. If yes, how regular: ..Specify gross amount: .. Specify gross amount: ..Specify income source: .. Specify income source: ..Pay day: .. Pay day: ..Occupation: .. Occupation: ..Employer name: .. Employer name: ..Employer address: .. Employer address: .. Code: .. Code: ..Employer/supervisor telephone number: .. Employer/supervisor telephone number.

8 Employed since: .. Employed since: ..Have you ever applied for debt counselling the NCA: Ye s No Have you ever applied for debt counselling the NCA: Yes No If yes, name the debt counsellor: .. If yes, name the debt counsellor: ..Has a NCA debt-rearrangement order ever been issued: Yes No Has a NCA debt-rearrangement order ever been issued: Yes No Have you ever been insolvent: Yes No Have you ever been insolvent: Yes No Have you ever been placed under an administration order: Yes No Has a NCA debt-rearrangement order ever been issued: Yes No If yes, please state date of rehabilitation: .. If yes, please state date of rehabilitation: ..Home language.

9 Home language: ..Communication channel: Phone SMS Email Post Communication channel: Phone SMS Email Post Do you have a post matric qualification: Yes No Do you have a post matric qualification: Yes No If yes, please confirm level: .. If yes, please confirm level: ..Please note that an incomplete form will not be : website: PO Box 15, Pretoria, 0001 City Property Administration (Pty) Ltd. Reg. No. 1968/010808/07E. APPLICANT/S BANK ACCOUNT DETAILSA pplicant 1: Applicant 2:Overdraft/budget facility: Yes No Overdraft/budget facility: Yes No If yes, please state overdraft/budget limit: .. If yes, please state overdraft/budget limit.

10 Name of the account holder: .. Name of the account holder: ..Bank: .. Bank: ..Account number: .. Account number: ..Branch: .. Branch: ..Branch code: .. Branch code: ..Type of account: Current Transmission Savings Type of account: Current Transmission Savings F. APPLICANT/S SURETY DETAILSA pplicant 1: Applicant 2:Full/Registered names: .. Full/Registered names: ..ID/Registration number: .. ID/Registration number: ..Telephone number: .. Telephone number: ..Mobile phone: .. Mobile phone: .. RESIDENTIAL address: .. RESIDENTIAL address: .. Code: .. Code: ..G. APPLICANT/S NEXT OF KIN DETAILS (Not to be an occupant)Applicant 1: Applicant 2:Full names: .. Full names: ..ID/Passport number.