Reference. Complex. Received by. MSUNDUZI HOUSING ASSOCIATION NPC Quality, Affordable Rental Accommodation

Transcription

1 FOR OFFICE USE ONLY Date Received Reference Complex Received by MSUNDUZI HOUSING ASSOCIATION NPC Quality, Affordable Rental Accommodation 41 Peter Kerchhoff Street, Pietermaritzburg, 3201 Tel: /7 Fax: / APPLICATION FOR ACCOMMODATION We thank you for showing interest in our rental units. In order for us to process your application as speedily as possible, please ensure that all required information (incl. supporting documents, as listed below) is included in this application and submitted to Msunduzi Housing Association. If you require any help in completing this application form, please contact MHA on ( /7). Requirements (Please provide all these documents on application) Current Payslip (not older than 3 months) Certified ID of Applicant Certified ID of Spouse/Partner (If applicable) Certified Marriage Certificate (if applicable) Certified Death Certificate (if applicable) Certified Birth Certificates/ID of all dependents if minors Affidavit declaring unemployment of spouse (if applicable) / Letter from Department of Labour declaring unemployment (if applicable) 3 months Bank Statements Details of Vehicle ( Registration Disc/ Log Book/ Letter of authorisation if vehicle is not in your name) If you have your own small business you will be required to provide 6 months bank statements and a letter of drawings from your accountant who should be a registered accounting officer in terms of the relevant and applicable acts and laws of the Republic of South Africa. All application fees payable are non-refundable 1

2 A PERSONAL PARTICULARS (Please complete all items, or mark with an X where applicable) Applicant Spouse/Partner 1. Surname 2. First Name/s 3. Alias (if applicable) 4. Sex 5. Date of birth 6. Identity number 7. Marital status Single Co-habiting Married Divorced Widow 8. Citizenship 9. Permanent Residential Address 10. Your telephone number 11. Your cell phone number 12. Name of employer 13. Employer s address 14. Telephone Number 15. Facsimile Number 16. address 17. Employee number and Department 18. Occupation 19. Income Per month Per month 2

3 20. Number of Dependants 21. Size of accommodation Required 22. Have you Previously been an MHA tenant? Why did you leave? 23. In your present home, are you Living with your parents Staying with friends Renting from a Private Landlord An MHA Tenant Lodging(with meals provided) _ Living with relatives An Owner occupier A Council Tenant Living in Institutional Care Other ( please detail below) 24. Have you ever been evicted for rent arrears Or causing a nuisance? Yes No If yes please give details 3

4 B PARTICULARS OF DEPENDANTS No Surname and First Name/s Date of birth Relationship Sex Name of current school (if minor) 1 Income (per month) C OTHERS Particulars of other persons that live with you now/or people not living with you now but who would live with you if MHA offered you accommodation No Surname and first name/s Date of birth Relationship Sex Name of current school 1 (if minor) Income (per month) 2 Why are the people listed in (C) not living with you now and why do they want to live with you? D PREVIOUS ADDRESSES Please give your previous address if you have lived in your present accommodation for less than 5 years Address Tenure e.g Owner,Council Tenant, Living with relatives etc Dates From Date To E SPECIAL NEEDS Do you or someone who lives with you have: A medical condition? Yes No A special need? Yes No A physical disability which requires the use of a wheelchair Yes No Please provide details.... The MHA requires a medical specialist s letter for any conditions listed above ( Please note that although the MHA may allocate you to a unit which is conducive to your condition it does not compel the MHA to do so nor does it compel the MHA to relax any requirements in terms of the lease agreement should the applicant be successful) 4

5 F MOTOR VEHICLE DETAILS Do you own a vehicle? Yes No Vehicle Registration Number Vehicle Make, Model and colour Registered Owner Relationship to you G Where did you hear about the available accommodation? Please specify Pamphlet/Flyer Internet Newspaper Radio Billboard Word of Mouth H DECLARATION BY APPLICANT 1. I agree to allow Msunduzi Housing Association to check my credit record. 2. I declare that the information I have given in the foregoing statements is true and current. 3. I agree that I must qualify in terms of current Housing legislation at the time of signing any legal contract with the Msunduzi Housing Association concerning accommodation. 4. I am aware that false statements on any documents relating to housing will render any such contract signed by me to become invalid and may lead to prosecution 5. I hereby confirm that I have personally inspected the premises and accept that in event of my failure to assume tenancy of this application or any written agreement of the lease pursuant thereto the following Cancellation Fees will charged, should I decide to withdraw after paying the deposit, I will be liable for an administration fee of R if I have completed Tenant Training and signed a Lease Agreement with the MHA, an administration fee of R1000 will be charged. 6. I am aware and consent to my application fees being forfeited should I not qualify for accommodation 7. I agree that I will attend the compulsory tenant interview/training sessions SIGNATURE DATE 5

6 HOUSEHOLD CASHFLOW NAME:.. INCOME GROSS SALARY APPLICANT DEDUCTIONS - APPLICANT NET SALARY - APPLICANT EXPENDITURE (Items not reflected on payslip) RENT WATER & ELECTRICITY TELEPHONE GROCERIES & OTHER FOOD GROSS SALARY APPLICANT 2 DEDUCTIONS APPLICANT 2 NET SALARY APPLICANT 2 TRAVELLING COSTS ENTERTAINMENT INSURANCE LIFE/ENDOWMENT INS: HOUSEHOLD/CAR RETIREMENT OTHER (Please specify) INS: FUNERAL INS: RETIREMENT MEDICAL COSTS H/P & OPEN ACCOUNTS BANK LOAN REPAYMENTS CREDIT CARD CAR INSTALMENT CLOTHING MAINTENANCE SCHOOL FEES OTHER TOTAL INCOME (A) TOTAL EXPENDITURE (B) NET CASH FLOW (A-B) SIGNATURE: WITNESS: 6