RENTAL APPLICATION PERSONAL DETAILS Title First Name Surname Email Cell Number Home Number Date of Birth I.D. Number Marital Status —Please choose an option—SingleMarriedDivorced SPOUSES DETAILS Title First Name Surname Email Cell Number Occupation I.D. Number EMPLOYER DETAILS Employer Work Number Occupation Gross Monthly Income - Applicant Gross Monthly Income - Household RESIDENTIAL INFORMATION Type of Residence —Please choose an option—FlatTownhouseHouseGarden CottageRoom Residential Status —Please choose an option—RenterLodgerOwnerLive with parents LANDLORD DETAILS First Name Surname Email Cell Number APPLICANT ADDRESS Address Line 1 Address Line 2 Address Line 3 Area Code Is your postal address the same as your physical address? YesNo POSTAL ADDRESS Address Line 1 Address Line 2 Address Line 3 Area Code PERSONAL REFERENCE #1 First Name Surname Cell Number Relationship PERSONAL REFERENCE #2 First Name Surname Cell Number Relationship WHAT PRODUCT/S ARE YOU INTERESTED IN? 4 x 4 UpgradeEezi-AwnGeneratorInverterMetal DetectorRoboguardRoofPodSolarSolar GeyserToolsWater Storage 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
