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GYMadmin2019-09-16T07:36:12+00:00

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QUESTIONNAIRE FOR NATURAL PERSONS

Please complete in full

Are you dealing with SHIBBOLET ESTATES on behalf of yourself or on behalf of another person (ie a Principal)?*

Myself

Another person

PERSONAL DETAILS

Full name and Surname*

SA Identity or foreign passport number (i.e. the person completing this Questionnaire)*

(Your SA ID or foreign passport must be inspected by us and a copy will be required from you)

Are you a South African citizen / permanent resident?*

What is the address of your main place of residence?

(A document less than 2 months old proving this main place of residence will be required from you)*

E-mail*

Phone Number

Do you have a South African income tax number issued by SARS? If so please furnish it

ON BEHALF OF ANOTHER PERSON (IE A PRINCIPAL)

What is the Principal's full Full name and Surname

What is the Principal's SA Identity or foreign passport number

(Their SA ID or foreign passport must be inspected by us and a copy will be required from you. If the original document is not available for inspection, a certified copy must be provided.)

Are they a South African citizen / permanent resident?

Yes

No

What is the address of their main place of residence?

(A document less than 2 month old proving this main place of residence will be required from you)*

What is their E-mail address

What is their Phone Number

Do they have a South African income tax number issued by SARS? If so please furnish it

Please indicate your authority to dealing with SHIBBOLET ESTATES on behalf of another person (i.e. authorisation letter, power of attorney, or a similar instrument)

Provide us with a copy of such a document

If, following your completion of this Questionnaire, will someone else deal with SHIBBOLET ESTATES on your behalf (i.e. a Representative)*

Yes

No

REPRESENTATIVE DETAILS

What is that Representative's Full name and Surname

What is that Representative's SA Identity or foreign passport number

What is the source of that Representative's authority to deal with SHIBBOLET ESTATES on your behalf (i.e. authorisation letter, power of attorney, or a similar instrument)

If the authority is in writing, provide us with a copy of such a document.

Please describe the type of service you seek from SHIBBOLET ESTATES, and the purpose for which that service is sought.*

I wish to sell a property

I wish to purchase a property

I wish to let out a property

I wish to rent a property

Other

Please specify

How will any payments due to SHIBBOLET ESTATES, or the other party to the prospective Business Relationship, be financed?

Will any of the payments referred to in the previous question involve a payment by you or your Representative of R25 000 or more in cash (i.e. paper money, coins or traveller's cheques)?*

Yes

No

Do you now occupy, or have you in the past 12 months occupied, any of the following positions in any country other than South Africa? If "yes", please indicate the position that you occupy/ied.*

Head of state

Member of the royal family

Cabinet member

Senior member of a political party

Senior judicial officer

Senior executive of a state-owned entity

High rank in the military

Do you now occupy, or have you in the past 12 months occupied, any of the following positions in South Africa? If "yes", please indicate that position that you occupy/ied.*

President or deputy president of South Africa

Cabinet minister or deputy minister

Premier of a province

MEC of a province

Mayor of a municipality

Leader of a political party

Member of a royal family

Senior traditional leader

Head, accounting officer or CFO of a national or provincial department

Manager or CFO of a municipality

Chairperson, CEO, accounting authority, CFO or chief investment officer of a public entity

Judge

Ambassador, high commissioner or other senior representative of a foreign country based in South Africa

Chairperson of board of directors, chairperson of audit committee, executive officer or CFO of a company doing business with the government, and if so, in what amount?

Are you a family member or a close associate of one of the categories of people mentioned in the previous 2 questions? If so, please name such person and indicate the position they occupied.

If you responded "yes" to any of the previous 3 questions, please indicate your source of wealth?

* Proof of your residential address can be furnished by way of a document emailed to you. In that case we will need to see the original email as it appeared in your inbox, and the attachment, (if any). That email and the attachment must then be emailed to us so that we can print a copy.

I / We declare that the information we have given in this application form is true and correct to the best of my/our knowledge and that I/we have not failed to provide any information which, if the Landlord had known such information, would have not allowed the application to be successful.

Initials/Signature*

Please type the characters. This helps us prevent spam.*

This field should be left blank

RENTAL APPLICATION FORM – RESIDENT

Please complete in full

Date

Complex name*

Unit number applied for*

Unit type

Bachelor

1 Bedroom

2 Bedroom

3 Bedroom

Occupation date as per discussion*

01 Dec – 30 Nov

01 Jan – 31 Dec

Other

Occupants*

Single

Sharing

Sharing with*

PERSONAL DETAILS

Full name and Surname*

Date of birth

Phone Number

Physical Address

Identity Number/ Passport Number*

Nationality*

Cell phone number*

Postal Address

E-mail*

Certified RSA ID Document / Passport*

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

Yes

No

If you are renting, please complete the following:

Current Landlord / Rental Agent

Telephone number

Cell phone number

Period of occupation

Previous Landlord / Rental Agent

Telephone number

Cell phone number

Period of occupation

Will you be studying at a tertiary institution?*

Yes

No

Kindly indicate at which tertiary institution:

Name of institution

Student number

DETAILS OF FRIEND / FAMILY MEMBER NOT RESIDING WITH YOU

Name & Surname

Relationship

Address

Contact number

PARENT / GUARDIAN DETAILS

Name & Surname

Employer

Relationship

Occupation

Address

Contact number

Email address

EMPLOYMENT DETAILS

Self-employed*

Yes

No

Occupation

Employment address

Employers telephone number

Current employer

Period of employment

Gross monthly salary

GENERAL DETAILS

Do you have any judgments or legal action (pending) against you?*

Yes

No

Please supply details

Do you have any hire purchase agreements or credit accounts? (I.e. Clothing or cellular contracts)*

Yes

No

Company 1

Company 2

Company 1 Account number

Company 2 Account number

I / We declare that the information we have given in this application form is true and correct to the best of my/our knowledge and that I/we have not failed to provide any information which, if the Landlord had known such information, would have not allowed the application to be successful.

Initials/Signature*

Please type the characters. This helps us prevent spam.*

This field should be left blank

RENTAL APPLICATION FORM – LESSEE

Please complete in full

Date

Complex name*

Unit number applied for*

Unit type

Bachelor

1 Bedroom

2 Bedroom

3 Bedroom

Occupation date as per discussion*

01 Dec – 30 Nov

01 Jan – 31 Dec

Other

Occupants*

Single

Sharing

Sharing with*

PERSONAL DETAILS

Full name and Surname*

Date of birth

Phone Number

Physical Address

Identity Number/ Passport Number*

Nationality*

Cell phone number*

Postal Address

E-mail*

Married?*

Yes

No

Spouse name and Surname

Spouse cell phone number

Spouse E-mail

Married in or out of community of property

in community of property

out of community of property

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

Yes

No

If you are renting, please complete the following:

Current or previous Landlord / Rental Agent

Telephone number

Cell phone number

Period of occupation

Will you, or the individual occupying the unit, study at a tertiary institution?*

Yes

No

Kindly indicate at which tertiary institution:

Name of institution

Student number

DETAILS OF FRIEND / FAMILY MEMBER NOT RESIDING WITH YOU

Name & Surname

Relationship

Address

EMPLOYMENT DETAILS

Self-employed*

Yes

No

Occupation

Employment address

Employers telephone number

Net monthly salary

Current employer

Period of employment

Gross monthly salary

Salary payment date

Income tax reference number

GENERAL DETAILS

Do you have any judgments or legal action (pending) against you?*

Yes

No

Please supply details

Do you have any hire purchase agreements or credit accounts? (I.e. Clothing or cellular contracts)*

Yes

No

Company 1

Company 2

Company 1 Account number

Company 2 Account number

Are you presently under, or have undergone, debt review proceedings?*

Yes

No

Who will be staying on the Premises for the whole period of the Lease?

Number of Adults

Number of Children (under 18 years of age)

Children’s ages

SUPPORTING DOCUMENTS TO BE ATTACHED WITH THIS APPLICATION

Certified RSA ID Document / Passport*

Certified proof of current address*

Bursary letter (if applicable)

3 x Certified proof of income*

Certified 3 Month’s original or bank stamped bank statements*

Surety letter (if applicable)

I / We declare that the information we have given in this application form is true and correct to the best of my/our knowledge and that I/we have not failed to provide any information which, if the Landlord had known such information, would have not allowed the application to be successful.

I / We consent that, and authorises the landlord or the agent to, at all times:-

contact, request and obtain information from any credit or service provider (or potential credit or service provider) or registered credit bureau relevant to an assessment of the behaviour, profile, payment patterns, indebtedness, whereabouts, and creditworthiness of the tenant;
furnish information concerning the behaviour, profile, payment patterns, indebtedness, whereabouts, and creditworthiness of the tenant to any registered credit bureau or to any credit or service provider (or potential credit or service provider) seeking a trade reference regarding the tenant’s dealings with the landlord.

Initials/Signature*

Please type the characters. This helps us prevent spam.*

This field should be left blank

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