Rent2Buy Application

Personal Information

Title —Select— Mr Mrs Miss Dr First Name Surname Email Cell Number Home Number Date of Birth ID Number Marital Status —Select— Single Married Divorced

Spouse Details

First Name Surname Cell Number Email

Employment Information

Employer Work Number Occupation Gross Monthly Income (Applicant) Gross Monthly Income (Household)

Residence Information

Type of Residence —Select— House Apartment Residential Status —Select— Own Rent Lodge Live with Parents Address Line 1 Address Line 2 Address Line 3 Area Code Postal Address Same? Yes No

Reference #1

First Name Surname Cell Number Relationship

Reference #2

First Name Surname Cell Number Relationship

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.

Yes No