RESIDENTIAL APPLICATION FORM

Tel: 021 424 1210 Fax: 021 423 4694 residential@daleglen.co.za www.daleglen.co.za

IMPORTANT NOTES: Copies of ID DOCUMENTS and PROOF OF INCOME (i.e. Payslip) of all Applicants to accompany this application. Pets / Animals may NOT under any circumstances be kept in or on the premises. Please ensure that the Application Form is completed in full in order to be eligible for consideration. Completion of this form does not guarantee that you will be accepted as a Lessee as final acceptance is that of the Lessor. Successful applicants are notified within three days. Should you not hear from our office in that time, your application is unsuccessful. A R125-00 credit check fee is payable by each Applicant once application has been accepted.

SECTION A
1 - ACCOMODATION APPLIED FOR: Flat / House: Garage No: No: Parking Bay No: Occupation Date:

Number of persons to occupy the premises (Including children):

SECTION B
2 - FIRST APPLICANT Surname: Full Names: Identity No: Do you have a clear credit record? Marital Status: Single YES Married A.N.C NO Married I.C.P Mr / Mrs / Ms / Other

Citizenship:

Tax number:
Other (Specify)

3 - CONTACT DETAILS Current Residential Address:

Residential Telephone No: E-mail Address: Duration at Current Address: Reasons for leaving: Present Landlord: Landlord's Telephone No: years months

Cell No:

Present Monthly Rental: R

Cell No:

4 - BANK & FINANCE DETAILS Name of Bank: Bank Account No: Car Registration Number: Amount owing: Financier: Branch:

Make and Model: Monthly Instalments: R

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RESIDENTIAL APPLICATION FORM

Tel: 021 424 1210 Fax: 021 423 4694 residential@daleglen.co.za www.daleglen.co.za

5 - EMPLOYMENT Name of Employer: Work Address: Contact Reference Person: Work Telephone No: Work Fax No: Occupation: Monthly Income: R Period Employed: Maintenance (If Any): R years months Cell No:

6 - REFERENCES OTHER THAN WORK Parents, Family or Friends (Not at the same address) 1 Name: Address: Home No: Cell No: 2 Name: Address: Home No: Cell No: 3 Name: Address: Home No: Cell No: Accounts: (e.g. Clothing / Credit Card) 1 2 Work No: Relationship: Work No: Relationship: Work No: Relationship:

Amount Owing: Amount Owing:

R R

SECTION C
7SPOUSE SECOND APPLICANT PERSON SHARING PARTNER (Please select) Surname: Full Names: Identity No: Do you have a clear credit record? Marital Status: Single YES Married A.N.C NO Married I.C.P Mr / Mrs / Ms / Other

Citizenship:

Tax number:
Other (Specify)

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RESIDENTIAL APPLICATION FORM

Tel: 021 424 1210 Fax: 021 423 4694 residential@daleglen.co.za www.daleglen.co.za

8 - CONTACT DETAILS Current Residential Address:

Residential Telephone No: E-mail Address: Duration at Current Address: Reasons for leaving: Present Landlord: Landlord's Telephone No: years months

Cell No:

Present Monthly Rental: R

Cell No:

9 - BANK & FINANCE DETAILS Name of Bank: Bank Account No: Car Registration Number: Amount owing: Financier: Branch:

Make and Model: Monthly Instalments: R

10 - EMPLOYMENT Name of Employer: Work Address: Contact Reference Person: Work Telephone No: Work Fax No: Occupation: Monthly Income: R Period Employed: Maintenance (If Any): R years months Cell No:

11 - REFERENCES OTHER THAN WORK Parents, Family or Friends (Not at the same address) 1 Name: Address: Home No: Cell No: 2 Name: Address: Home No: Cell No: Work No: Relationship: Work No: Relationship:

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RESIDENTIAL APPLICATION FORM

Tel: 021 424 1210 Fax: 021 423 4694 residential@daleglen.co.za www.daleglen.co.za

11 - REFERENCES OTHER THAN WORK (continue...) 3 Name: Address: Home No: Cell No: Accounts: (e.g. Clothing / Credit Card) 1 2 Work No: Relationship:

Amount Owing: Amount Owing:

R R

SECTION D
12 - ACKNOWLEDGEMENT: I/We declare that the above information is correct. I/We hereby confirm that I/we have personally inspected the interior of the premises applied for and accept the condition of the said premises as is. If the application is successful, I/we agree to sign Daleglen Property Group (Pty) Ltd's standard lease agreement and I/we shall be bound by all terms and conditions thereof. No agreement of lease shall be deemed to exist between the Lessor and myself until the lease has been signed by, or on behalf of, the Lessor. By submitting this application form, the applicant hereby consents and authorises the landlord and Daleglen Property Group (Pty) Ltd to: Contact, request and obtain information from any credit provider (Or potential credit provider) or registered credit bureau relevant to an assessment of the behaviour, profile, payment patterns, indebtedness, whereabouts and creditworthiness of the applicant. Furnish information concerning behaviour, profile, payment patterns, indebtedness, whereabouts and creditworthiness to any registered credit bureau or to any credit provider (Or potential credit provider) seeking a trade reference regarding the applicant's dealings with the Lessor. Signature: First Applicant Signature: Second Applicant Date: Date:

How did you get to know about Daleglen Property Group (Pty) Ltd? Newspaper Friends OFFICE USE ONLY: Rent: Garage: Parking Bay: Rental Deposit: Remote Deposit: Electricity Deposit: TPN Fees: Lease Fees: Cancellation fee: TOTAL Daleglen Website Other referals Gumtree To let sign Been tenant before Other tenants

Other (Please specify)

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R R R R R R R R R R

Credit check: Date approved:

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