RENTAL APPLICATION

PERSONAL DETAILS

[uacf7-row][uacf7-col col:6] Title
[/uacf7-col][uacf7-col col:6] First Name
[/uacf7-col][/uacf7-row]

[uacf7-row][uacf7-col col:6] Surname
[/uacf7-col][uacf7-col col:6] Email
[/uacf7-col][/uacf7-row]

[uacf7-row][uacf7-col col:6] Cell Number
[/uacf7-col][uacf7-col col:6] Home Number
[/uacf7-col][/uacf7-row]

[uacf7-row][uacf7-col col:6] Date of Birth
[/uacf7-col][uacf7-col col:6] I.D. Number
[/uacf7-col][/uacf7-row]

[uacf7-row][uacf7-col col:6] Marital Status
—Please choose an option—SingleMarriedDivorced [/uacf7-col][uacf7-col col:6] [/uacf7-col][/uacf7-row]

EMPLOYER DETAILS

[uacf7-row][uacf7-col col:6] Employer
[/uacf7-col][uacf7-col col:6] Work Number
[/uacf7-col][/uacf7-row]

[uacf7-row][uacf7-col col:6] Occupation
[/uacf7-col][uacf7-col col:6] Gross Monthly Income - Applicant
[/uacf7-col][/uacf7-row]

[uacf7-row][uacf7-col col:6] Gross Monthly Income - Household
[/uacf7-col][uacf7-col col:6] [/uacf7-col][/uacf7-row]

RESIDENTIAL INFORMATION

[uacf7-row][uacf7-col col:6] Type of Residence
—Please choose an option—FlatTownhouseHouseGarden CottageRoom [/uacf7-col][uacf7-col col:6] Residential Status
—Please choose an option—RenterLodgerOwnerLive with parents [/uacf7-col][/uacf7-row]

APPLICANT ADDRESS

[uacf7-row][uacf7-col col:6] Address Line 1
[/uacf7-col][uacf7-col col:6] Address Line 2
[/uacf7-col][/uacf7-row]

[uacf7-row][uacf7-col col:6] Address Line 3
[/uacf7-col][uacf7-col col:6] Area Code
[/uacf7-col][/uacf7-row]

Is your postal address the same as your physical address?
YesNo

PERSONAL REFERENCE #1

[uacf7-row][uacf7-col col:6] First Name
[/uacf7-col][uacf7-col col:6] Surname
[/uacf7-col][/uacf7-row]

[uacf7-row][uacf7-col col:6] Cell Number
[/uacf7-col][uacf7-col col:6] Relationship
[/uacf7-col][/uacf7-row]

PERSONAL REFERENCE #2

[uacf7-row][uacf7-col col:6] First Name
[/uacf7-col][uacf7-col col:6] Surname
[/uacf7-col][/uacf7-row]

[uacf7-row][uacf7-col col:6] Cell Number
[/uacf7-col][uacf7-col col:6] Relationship
[/uacf7-col][/uacf7-row]

DECLARATION

I hereby certify that all details in this application form are true and correct and I hereby acknowledge that the information is given for the purpose of assessing my ability to pay the monthly rental and understand that Digifax (Pty) Ltd t/a Digirent may investigate my payment history and report information concerning the conduct of my account to credit bureau and other entities.

I have read and accept the above declaration.
YesNo