Electronic Application From

Green Meadows – Application Form

Rental Application
Applicant Information
General Details

Order Number

Rental Application

Premises: (flat no) _______ Green Meadows, c/o Piet Bosman & Retief Street, Potchefstroom *

Where did you hear about Green Meadows *

Type of Flat *

Furnished or Unfurnished *

Size *

Monthly rent *

Deposit *

First Applicant Information

_{(Person responsible for payments)}

Full Name *

ID / Passport No (copy to be attached) *

Nationality *

Marital Status *

Telephone (Mobile) *

Date of Birth *

Email Address *

(Work)

Address where you currently stay *

Do you own fixed property ? *

Are you the owner of the property where you currently stay ? *

If NO, please provide the following:

Rental paid

Name of Rental Agent

Contact No

Self-Employed

Current Employer

Occupation

Employer's Telephone no

Net Monthly Salary (after deductions & tax) - (copy of payslip attached)

Current monthly expenses

Have you ever had any judgements / defaults granted against you ?

If YES, please provide details

Bank

Account No

Branch Code

Type of Account

Second Applicant Information

_{(Person responsible for payments)}

Full Name

ID / Passport No (copy to be attached)

Nationality

Marital Status

Telephone (Mobile)

Date of Birth

Email Address

(Work)

Address where you currently stay

Do you own fixed property ?

Are you the owner of the property where you currently stay ?

If NO, please provide the following:

Rental paid

Name of Rental Agent

Contact No

Self-Employed

Current Employer

Net Monthly Salary (after deductions & tax) - (copy of payslip attached)

Occupation

Employer's Telephone no

Current monthly expenses

Have you ever had any judgements / defaults granted against you ?

Bank

Account No

If YES, please provide details

Branch Code

Type of Account

General Details

_{Who will be staying at the Premises for the whole period of the Lease ?}

Tenant 1

Full Name(s) *

ID / Passport No (copy to be attached) *

Copy of ID / Passport *

Telephone (Mobile) *

(Work)

Email Address *

Tenant 2

Full Name(s)

ID / Passport No (copy to be attached)

Copy of ID / Passport

Telephone (Mobile)

(Work)

Email Address

Vehicles

Number of vehicles at the Premises *

Type *

Type

Registration *

Registration

Checklist

First Applicant

ID / Passport

Proof of current address

Payslip

3 Month's Bank Statements

Second Applicant

ID / Passport

Proof of current address

Payslip

3 Month's Bank Statements

I/We agree and allow the Landlord or Agent at all times to

Contact, request and obtain informationfrom any credit provider (or potential credit provider) or registered credit bureau that may be necessary to assess my/our behaviour, profile, payment patterns, indebtedness, whereabouts and creditworthiness

Furnish information concerning the behavior, profile payment patterns, indebtedness, whereabouts and creditworthiness of me/us to any registered credit bureau or any credit provider (or potential credit provider) seeking a trade reference regarding my/our dealings with the Landlord or Agent.

Applicant 1

Signed at *

on this day *

of *

20 *

Applicant 2

Signed at

on this day

018 880 0100

info@greenmeadows.co.za

Green Meadows – Application Form

Rental Application

First Applicant Information

If NO, please provide the following:

Second Applicant Information

If NO, please provide the following:

General Details

Tenant 1

Tenant 2

Vehicles

Checklist

I/We agree and allow the Landlord or Agent at all times to

Applicant 1

Applicant 2

Interesting Info

Address

Contact