QUALIFYING CRITERIA LISTING

Dear Sir/Madam,

Thank you for your interest in our available rental units.

Please note that our qualifying criteria is as follows :

• The main applicant needs to be at least 21 years of age or older;

• The main applicant must be a South African citizen;
• The main applicant must be permanently employed or receive a pension;
• Your combined monthly household net income must be between R4855 and R22000; and
• None of the occupants must own property

Should you qualify under the above-mentioned criteria, you are welcome to apply for a unit at one
of our projects. If your application is successful, you will be placed on a waiting list until such time
that a unit (for which you have been approved) becomes available.
Should you wish to apply, please note that there is a non-refundable application fee of R200.00
which needs to be paid into the bank account as indicated on the top right hand side of the
application form.

On the left side of the form is a list of documents which we will require in order to process your
application. Please ensure that you provide us with all the documents which have relevance to you.
Not handing all of the documents relevant to you could result in the outcome of your application
being delayed. All documents must be certified, except the bank statements. Bank statements must
be original with the bank stamp. All documents required from the main applicant must also be
provided for all occupants.

Application forms and documents cannot be faxed or emailed. Please arrange for the original
documentation to be delivered to the preferred project.

Please ensure that you read and understand the conditions of the application as stipulated on page
three (3) of the application form. Bear in mind that incorrect information provided by an applicant
can lead to the application being declined.

We wish you all the best in your search for your dream accommodation.

Regards

Client Services

I, ID state that I have read the

above qualifying criteria and hereby confirm that I (and all other occupants) have complied
herewith.

SIGNATURE DATE
 Walmer Link Fairview Link Willowdene Khwezi Uitenhage
14 Lungelo Mlandu Str Restitution Avenue Cnr Frank Landman & Willow Rd John Street
Walmer Fairview Fairview Uitenhage
Tel: 041 517 2813 Tel: 041 517 3066 Tel: 041 001 1112 Tel: 041 450 6264
Email: admin@imizi.co.za Email: admin@imizi.co.za Email: admin@imizi.co.za Email: admin@imizi.co.za

TENANT APPLICATION FORM PROJECT :

Introduction:
We thank you for showing interest in our units for rental. In order for us to process your application as speedily as
possible, please ensure that all required information (incl. certified supporting documents as listed below) are included
in this application and submitted to IMIZI Housing.
Your combined monthly household net income must be between R4855 and R22000. By ticking this box I confirm that I
Certified Supporting Documents : am aware of the non-refundable
● Current Payslip and Letter from employer for all employed occupants application fee of R200 which will be
● Identity Document of Applicant levied on each and every application.
● Identity Document of all occupants over the age of 16 BANK DETAILS FOR FEE AS FOLLOWS:
● Marriage, divorce or death Certificate (where applicable) Bank: FIRST NATIONAL BANK
● Birth Certificates of Dependants under the age of 16 Account name: IMIZI
● Copy of SASSA Card and SASSA letter (if applicable) Account number: 62098456439
● Bank statements of all occupants (no less than 6 months) Branch code: 261050
● Personal Budget Form and Supporting Documents Branch name: NEWTON PARK
● IRP 5 / Tax Certificate (IT 3) Reference: Name & Surname
● Affidavit from all persons over 18 years who are unemployed

A. Personal Particulars :
APPLICANT
SURNAME
FIRST NAME/S DATE OF BIRTH
IDENTITY NUMBER
NATIONALITY
CITY/POSTAL CODE
TELEPHONE (H) CELL PHONE
CURRENT EMPLOYER
OCCUPATION MANAGER/HR OFFICE
EMPLOYERS' ADDRESS

TELEPHONE (W) LENGTH OF SERVICE

EMAIL VEHICLE REGISTRATION NO.

SPOUSE/PARTNER
SURNAME
FIRST NAME/S DATE OF BIRTH
IDENTITY NUMBER
NATIONALITY
CITY/POSTAL CODE
TELEPHONE (H) CELL PHONE
CURRENT EMPLOYER
OCCUPATION MANAGER/HR OFFICE
EMPLOYERS' ADDRESS

TELEPHONE (W) LENGTH OF SERVICE

EMAIL VEHICLE REGISTRATION NO.
B. Household Composition (Persons to take full time occupation)
SINGLE ‫ﬦ‬ COUPLE Married or Cohabiting ‫ﬦ‬ COUPLE with children ‫ﬦ‬ SINGLE PARENT with children ‫ﬦ‬
NAME DATE OF BIRTH RELATIONSHIP EMPLOYMENT STATUS

C. Residency History :
Please list your residential address(es) for the past 2 years.
1. ADDRESS FROM
TO DATE LANDLORD NAME LANDLORD NUMBER
2. ADDRESS FROM
TO DATE LANDLORD NAME LANDLORD NUMBER
Indicate your current housing situation.
APPLICANT
HOME OWNER ‫ﬦ‬ LIVING WITH FAMILY ‫ﬦ‬ RENTAL APARTMENT OR HOUSE ‫ﬦ‬ INFORMAL ‫ﬦ‬
SPOUSE / PARTNER / OCCUPANTS
HOME OWNER ‫ﬦ‬ LIVING WITH FAMILY ‫ﬦ‬ RENTAL APARTMENT OR HOUSE ‫ﬦ‬ INFORMAL ‫ﬦ‬
IF RENTING, PLEASE INDICATE BASIC RENT PER MONTH

DO YOU ARE ANY OCCUPANT CURRENTLY OR HAVE EVER OWNED PROPERTY / HOUSE Yes No
IN SOUTH AFRICA?
DO YOU OR ANY OCCUPANT CURRENTLY OR HAVE EVER OWNED A RDP HOUSE Yes No
IN SOUTH AFRICA?
HAVE YOU OR ANY OCCUPANT RECEIVED A GOVERNMENT HOUSING SUBSIDY BEFORE? Yes No
WILL YOU BE JOINED BY YOUR PARTNER/SPOUSE/ANYONE ELSE IN A FEW MONTHS TIME? Yes No
ARE ANY OF THE OCCUPANTS EMPLOYED? Yes No

NEXT OF KIN:
NAME & SURNAME TEL RELATIONSHIP
ADDRESS

D. Income Particulars
APPLICANT
FORMAL LABOUR ‫ ﬦ‬INFORMAL TRADE ‫ ﬦ‬PENSION ‫ ﬦ‬DISABILITY GRANT ‫ ﬦ‬MAINTENANCE ‫ ﬦ‬OTHER (Please specify) ‫ﬦ‬
SPOUSE / PARTNER / OCCUPANTS
FORMAL LABOUR ‫ ﬦ‬INFORMAL TRADE ‫ ﬦ‬PENSION ‫ ﬦ‬DISABILITY GRANT ‫ ﬦ‬MAINTENANCE ‫ ﬦ‬OTHER (Please specify) ‫ﬦ‬
List basic monthly income (before deductions) for all members of your household taking occupation, from all sources
NAME SOURCE (Employment. Pension, Etc.) Monthly Income

TOTAL BASIC MONTHLY INCOME FOR HOUSEHOLD R

E. Marketing Information
Where did you hear about us?
WORD OF MOUTH ‫ ﬦ‬NEWSPAPER ‫ﬦ‬ WEBSITE ‫ ﬦ‬FACEBOOK ‫ ﬦ‬RADIO ‫ﬦ‬
F. Terms and Conditions of Application
1. No animals allowed.
2. Number of occupants is limited to two persons per bedroom.
3. Electricity and water are NOT included in the rental - Electricity is prepaid and water is metered.
4. Damage deposit will be held in an interest bearing account and cannot be utilised as rental.
5. Two months' damage deposit and one month's rent is payable before taking occupation.
6. Before vacating, an inspection will be carried out with the Caretaker and submitted to IMIZI .
7. On vacating, costs of cleaning, repairs and repainting the unit will be deducted from damage deposit.
8. Rental, water, refuse collection and/or parking is payable on or before 1st of every month in advance.
9. Debit order is the mandatory method of payment.
10. Annual rental increases will take place.
11. Annual Municipal increases take effect annually in accordance with the Municipality.
12. Completing and signing this application form is no guarantee of approval for a rental unit.
13. IMIZI or tenant have the right to give one calendar months' notice of cancellation of lease agreement should its clauses
not be upheld as well as stipulations of Tenant Handbook.
14. The units are strictly rent to rent and not rent to buy.
15. Once approved and the deposit and first months rental has been paid, the applicant will be placed on a waiting list for
the next available unit. There is no guaranteed time period to the waiting list.

G. Signature
I declare that I have read this form carefully and I also hereby give consent to the Landlord at all times to:
a) Contact, request and obtain information from any credit provider (or potential credit provider) or registered
credit bureau relevant to an assessment of the behaviour profile, payment pattern, indebtedness, whereabouts
and creditworthiness of the tenant and all occupants.
b) Furnish information concerning the behaviour, profile, payment pattern, indebtedness, whereabouts and
creditworthiness of the tenant or occupant to any registered credit bureau or to any credit provider
(or potential credit provider) seeking a trade reference regarding the tenants/occupants dealings with the
Landlord.
c) Contact or request to obtain information concerning criminal convictions of the applicant and occupant from
SAPS.
I declare that the following information which I have furnished is correct:
* Residency History;
* Spouse/Partner;
* Bank Accounts;
* Payslips and/or Declaration of Income;
* Occupants;
* Full list of expenditure.
I understand that if any of it is found to be untrue and incorrect, the application will not be approved and if the
application is approved based on such information the lease agreement may be cancelled with immediate
effect.
APPLICANT SPOUSE / PARTNER / OCCUPANTS
PLACE PLACE

DATE DATE

SIGNATURE SIGNATURE
BANK DETAILS OF APPLICANT
BANK NAME: ACCOUNT HOLDER NAME AND SURNAME
BRANCH CODE ACCOUNT TYPE ACCOUNT NUMBER

BANK DETAILS OF SPOUSE / PARTNER

BANK NAME: ACCOUNT HOLDER NAME AND SURNAME
BRANCH CODE ACCOUNT TYPE ACCOUNT NUMBER

GENERAL
* WHEN WOULD YOU NEED TO OCCUPY YOUR ACCOMMODATION? Month Year
* WOULD YOU REQUIRE PARKING FOR A CAR? (Extra Cost) YES NO (No visitor/s parking) REG NO.
*IF YOUR APPLICATION IS SUCCESSFUL YOU WOULD BE REQUIRED TO ATTEND A TENANT EDUCATION COURSE WHICH IS COMPULSORY.
*ARE YOU OR ANY OF YOUR DEPENDENTS DISABLED AND REQUIRE WHEELCHAIR ACCESS? YES NO

WHAT QUALIFICATION(S) OR SKILLS DO YOU HAVE? (All members within the household)
QUALIFICATION(S) / SKILLS SPECIFICATION
Matric
NQF
Tertiary
Artisan
Other

RECOMMENDATIONS FOR FUTURE PROGRAMMES:

REASON FOR APPLICATION

Please note that this is purely for statistical purposes and will not influence your eligibility.

Please tick any of the following:

AFFORDABILITY ‫ﬦ‬

CLOSER TO PLACE OF EMPLOYMENT ‫ﬦ‬

SAFETY AND SECURITY ‫ﬦ‬

CLOSER TO FAMILY ‫ﬦ‬

SOLD OWN PROPERTY ‫ﬦ‬

RETIREMENT ‫ﬦ‬

OTHER (Please Specify) ‫ﬦ‬

 HOUSEHOLD PERSONAL BUDGET FORM
NETT INCOME (As per Payslip) R c
Applicant

Spouse / Partner / Occupants

Other (Grant, Pension, Maintenance)

TOTAL INCOME

EXPENDITURE R c
Church / Charity

Rent

Groceries

Savings

Transport Costs

Clothing

Loans (All types)

School Fees

Insurances

Municipal Water and Electricity

Telephone / Airtime / Cell Contracts

Family Support

Medical

Entertainment

Garnishee
Other (Specify)

TOTAL EXPENDITURE

TOTAL INCOME PER ABOVE

TOTAL EXPENDITURE PER ABOVE

NETT CASH FLOW