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: .. If not, permit number: .. Permit expiry date.

2 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:.. Doctors and chemists:..Gambling: .. Gambling: ..Groceries:.. Groceries:..Housekeeper.

4 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: .. 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.

5 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: .. 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.

6 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: ..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.

7 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: ..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.

8 If yes, please state date of rehabilitation: ..Home language: .. 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: ..Name of the account holder.

9 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: .. ID/Passport number: ..Telephone number: .. Telephone number: ..Mobile phone: .. Mobile phone: .. RESIDENTIAL address: .. RESIDENTIAL address.

10 Code: .. Code: ..Employer name: .. Employer name: ..Employer telephone number: .. Employer telephone number: ..Relationship to applicant: .. Relationship to applicant: ..H. APPLICANT/S OCCUPANTS (Not to be next of kin)How did you hear about us: Website Mobisite Facebook Twitter Promotions Pamphlets Newspaper PTA News Junkmail Daily Sun Record Show office Cold Calling Referral Replacement tenant Returning tenant Other ..Please note that an incomplete form will not be AND SURNAMEID/PASSPORT NUMBERCELL NUMBERSTUDENT (YES/NO)email: website: PO Box 15, Pretoria, 0001 City Property Administration (Pty) Ltd. Reg. No. 1968/010808/07I. TERMS AND CONDITIONS1. I/We the undersigned (hereinafter referred to as the tenant ), hereby warrant that the information contained in this APPLICATION is true and correct.