Property you are interested in (Address / Area / Listed Price)

Preferred date of occupation

Full Name and Surname

Cellphone Number

WhatsApp Number

Email Address

Country of Birth

Do you have a partner?
YesNo

Country of birth of your partner (if applicable)

Your Occupation

Employment Type
Salaried EmployedSelf Employed

Employment or Business Details (Company & branch OR business type & location)

Estimated net monthly income (R)

Is your credit record clear?
YesNo

If not, please provide details (financial institution and reason)

Do you have a clear criminal record?
YesNo

If not, please provide details

Will anyone staying at the unit have a disability?
YesNo

Do you have any pets? If yes, specify type and number

Number of occupants (Adults and children, including ages)

Do you have children of your own?
YesNo

Age(s) of your children

Does your partner have children?
YesNo

Age(s) of partner’s children

Intended rental period (e.g. 6 months / 12 months)

Do you have any chronic illness(es)?

Do you require parking? If yes, number of vehicles

Monthly rental budget (R)

Type of space required (Bachelor / 1 Bedroom / 2 Bedroom / Room)

Reason for relocating or seeking a new rental property

Current or previous landlord / agent name

Landlord / agent contact number

Any special requirements or additional information

I confirm that all information provided is true and correct.