ONLINE APPLICATION - Imizi Housing

APPLICATION FORM

To apply for rental housing with Imizi Housing Utility , please fill in all the fields
Applicant declaration I declare that the information I have provided is true and current. I agree that Imizi Housing Utility NPC may check my credit record. I agree that my personal information may be processed in terms of the POPI Act.

I am aware that my combined household nett income must not exceed R22000 per month to be eligible.

I am aware that there is a non-refundable application fee of R200.00 payable for each application.

Please deposit R200.00 into:

Account Name: Imizi Housing Utility
Bank: FNB
Branch: 2610050
Account Number: 62098456439
Reference: Your Surname & Initials

Please include the proof of payment with the documents that you upload later, or email a proof of payment to applications@imizi.co.za.

I agree that I will attend the compulsory tenant interview/training sessions, should my application be approved.

Please enable JavaScript in your browser to complete this form.

1PERSONAL DETAILS

2PRE QUALIFICATION

3RESIDENTIAL HISTORY

4UNIT

5APPLICANT DETAILS

6OTHER APPLICANT DETAILS

7EMPLOYER

9SUBMIT

Full Name *

First

Middle

Last

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Phone *

Email *

Layout

Title

Initials

Gender

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Relationship *

Single
Married
Divorced

Do you have any children / dependents that stay with you? *

To see if you qualify for rental housing, please fill in the fields below

Layout

I am a south african citizen *

My / our total household Nett income is less than R22000.00 *

I / we give consent to Imizi Housing conducting a credit check on me and every other adult applicant on this form *

I do have ID, payslips, and bank statements ready in .PDF, .JPEG format *

I/we am/are not under debt review or insolvent *

I have a bank account *

I / we give consent to my / our information being held in terms with the POPI Act *

I/we do not have nor ever had property (OR RDP HOUSE) registered in my / our name currently *

I have NOT applied for an RDP house in the last 12 months *

Please list your residential address(es) for the past 2 years.

Residential address *

Address Line 1

City

State / Province / Region

Postal Code

Country

How long did you stay there *

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Landlord Name *

Landlord Phone

If less than two years please provide details of addresses and contact detail of landlord

Additional residential address information.

Indicate your current housing situation. *

Home Owner
Living with Family
Rental Apartment or House
Informal

Have you or any occupant received a government housing subsidy before? *

Are you a current tenant at our developments? *

Are you married/co-habiting? *

Next of Kin

First

Last

Layout

Next of Kin Phone

Next of Kin Relationship

Next of Kin Email

Next of Kin Address

Address Line 1

City

State / Province / Region

UNIT

Property interested in first choice *

Fairview Link
Walmer Link
Willowdene
Khwezi

Property interested in second choice

Fairview Link
Walmer Link
Willowdene
Khwezi

Layout

I am interested in *

Studio
1 Bedroom
2 Bedroom
3 Bedroom

Do you require parking *

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How many adults will be staying in the unit?

1 : Adults

How many children below 18 years will be staying in the unit?

1 : Children

APPLICANT DETAILS

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Confirm Email *

Confirm Phone *

Your date of birth *

Your ID number *

Residential address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Postal Address (If Different from Residential address)

APPLICANT DETAILS

Layout (copy)

Confirm Applicant Two Email (If Applicable)

Confirm Applicant two Phone (If Apllicable) *

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Title (Applicant Two)

Initials (Applicant Two)

Gender (Applicant Two)

Your date of birth (Applicant Two)

Your ID number (Applicant Two)

Residential address (Applicant Two)

Address Line 1

City

State / Province / Region

Postal Code

Country

Postal Address (If Different from Residential address) (copy)

Layout

Have you ever been evicted for rental arrears / other reasons

If "Yes" please state why

Do you have special needs?

If "Yes" please specify

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Please upload ID Copies for each applicant *

Click or drag files to this area to upload. You can upload up to 5 files.

Please provide 6 months’ bank statements for each applicant/ if self-employed, 6 months’ company bank statement, and proof of company registration (CK document) *

Click or drag files to this area to upload. You can upload up to 20 files.

Please provide last 3 months payslips for each applicant / if self-employed a letter of drawings from your accountant *

Click or drag files to this area to upload. You can upload up to 8 files.

If already paid please upload your proof of payment.

Click or drag a file to this area to upload.

Other Occupants 1

Full Name OP 1

First

Middle

Last

Layout

Date of Birth OP 1

Mobile if Applicable OP 1

Email if applicable OP 1

School Attending OP 1

Other Occupants 2

Full Name OP 2

First

Middle

Last

Layout (copy)

Date of Birth OP 2

Mobile if Applicable OP 2

Email if applicable OP 2

School Attending OP 2

Other Occupants 3

Full Name OP 3

First

Middle

Last

Layout (copy) (copy)

Date / Time OP 3

Mobile if Applicable OP 3

Email if applicable OP 3

School Attending OP 3

EMPLOYER

(if Self employed state “Self Employed” )

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Name of your company

Job title

Office telephone number

Gross monthly income (before deductions)(ZAR)

Contact person

Department

Company Address

Indicate if you are

EMPLOYER

(If self employed , leave blank )

Layout

Name of your company

Job title

Office telephone number

Gross monthly income (before deductions)(ZAR)

Contact person

Department

Company Address

Indicate if you are

INCOME

Income for all occupants

GROSS salary (ZAR)

Deductions (ZAR)

Net salary (ZAR)

Total monthly household income

Expenditure for whole household (Items not reflected on payslip)

Rent (ZAR)

Water and electricity

Phone Costs (ZAR)

Groceries (ZAR)

Travel costs (ZAR)

Insurance (Vehicle)

Insurance (Other)

School fees (ZAR)

Clothing (ZAR)

Funeral policy

Medical Aid (ZAR)

Account - Furniture (ZAR)

Family Support (ZAR)

Child Support (ZAR)

Bank Loan repayments (ZAR)

Credit card instalments (ZAR)

Motor vehicle instalments (ZAR)

Entertainment (ZAR)

Other (ZAR)

Total

R0.00

Conditions *

Yes, I the undersigned, do hereby confirm that all the information contained in this application for is true and correct and that I have disclosed all material facts

"Please note you may be requested to visit our office to provide original documentation if necessary , you will be contacted if required "

Layout

Signature *

Date *

APPLICATION FORM

I am aware that my combined household nett income must not exceed R22000 per month to be eligible.

I am aware that there is a non-refundable application fee of R200.00 payable for each application.

Please deposit R200.00 into:

Account Name: Imizi Housing Utility
Bank: FNB
Branch: 2610050
Account Number: 62098456439
Reference: Your Surname & Initials

Please include the proof of payment with the documents that you upload later, or email a proof of payment to applications@imizi.co.za.

I agree that I will attend the compulsory tenant interview/training sessions, should my application be approved.

Please enable JavaScript in your browser to complete this form.

1PERSONAL DETAILS

2PRE QUALIFICATION

3RESIDENTIAL HISTORY

4UNIT

5APPLICANT DETAILS

6OTHER APPLICANT DETAILS

7EMPLOYER

9SUBMIT

Full Name *

First

Middle

Last

Layout

Phone *

Email *

Layout

Title

Initials

Gender

Layout

Relationship *

Single
Married
Divorced

Do you have any children / dependents that stay with you? *

To see if you qualify for rental housing, please fill in the fields below

Layout

I am a south african citizen *

My / our total household Nett income is less than R22000.00 *

I / we give consent to Imizi Housing conducting a credit check on me and every other adult applicant on this form *

I do have ID, payslips, and bank statements ready in .PDF, .JPEG format *

I/we am/are not under debt review or insolvent *

I have a bank account *

I / we give consent to my / our information being held in terms with the POPI Act *

I/we do not have nor ever had property (OR RDP HOUSE) registered in my / our name currently *

I have NOT applied for an RDP house in the last 12 months *

Please list your residential address(es) for the past 2 years.

Residential address *

Address Line 1

City

State / Province / Region

Postal Code

Country

How long did you stay there *

Layout

Landlord Name *

Landlord Phone

If less than two years please provide details of addresses and contact detail of landlord

Additional residential address information.

Indicate your current housing situation. *

Home Owner
Living with Family
Rental Apartment or House
Informal

Have you or any occupant received a government housing subsidy before? *

Are you a current tenant at our developments? *

Are you married/co-habiting? *

Next of Kin

First

Last

Layout

Next of Kin Phone

Next of Kin Relationship

Next of Kin Email

Next of Kin Address

Address Line 1

City

State / Province / Region

UNIT

Property interested in first choice *

Fairview Link
Walmer Link
Willowdene
Khwezi

Property interested in second choice

Fairview Link
Walmer Link
Willowdene
Khwezi

Layout

I am interested in *

Studio
1 Bedroom
2 Bedroom
3 Bedroom

Do you require parking *

Layout

How many adults will be staying in the unit?

1 : Adults

How many children below 18 years will be staying in the unit?

1 : Children

APPLICANT DETAILS

Layout

Confirm Email *

Confirm Phone *

Your date of birth *

Your ID number *

Residential address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Postal Address (If Different from Residential address)

APPLICANT DETAILS

Layout (copy)

Confirm Applicant Two Email (If Applicable)

Confirm Applicant two Phone (If Apllicable) *

Layout (copy)

Title (Applicant Two)

Initials (Applicant Two)

Gender (Applicant Two)

Your date of birth (Applicant Two)

Your ID number (Applicant Two)

Residential address (Applicant Two)

Address Line 1

City

State / Province / Region

Postal Code

Country

Postal Address (If Different from Residential address) (copy)

Layout

Have you ever been evicted for rental arrears / other reasons

If "Yes" please state why

Do you have special needs?

If "Yes" please specify

Layout

Please upload ID Copies for each applicant *

Click or drag files to this area to upload. You can upload up to 5 files.

Please provide 6 months’ bank statements for each applicant/ if self-employed, 6 months’ company bank statement, and proof of company registration (CK document) *

Click or drag files to this area to upload. You can upload up to 20 files.

Please provide last 3 months payslips for each applicant / if self-employed a letter of drawings from your accountant *

Click or drag files to this area to upload. You can upload up to 8 files.

If already paid please upload your proof of payment.

Click or drag a file to this area to upload.

Other Occupants 1

Full Name OP 1

First

Middle

Last

Layout

Date of Birth OP 1

Mobile if Applicable OP 1

Email if applicable OP 1

School Attending OP 1

Other Occupants 2

Full Name OP 2

First

Middle

Last

Layout (copy)

Date of Birth OP 2

Mobile if Applicable OP 2

Email if applicable OP 2

School Attending OP 2

Other Occupants 3

Full Name OP 3

First

Middle

Last

Layout (copy) (copy)

Date / Time OP 3

Mobile if Applicable OP 3

Email if applicable OP 3

School Attending OP 3

EMPLOYER

(if Self employed state “Self Employed” )

Layout

Name of your company

Job title

Office telephone number

Gross monthly income (before deductions)(ZAR)

Contact person

Department

Company Address

Indicate if you are

EMPLOYER

(If self employed , leave blank )

Layout

Name of your company

Job title

Office telephone number

Gross monthly income (before deductions)(ZAR)

Contact person

Department

Company Address

Indicate if you are

INCOME

Income for all occupants

GROSS salary (ZAR)

Deductions (ZAR)

Net salary (ZAR)

Total monthly household income

Expenditure for whole household (Items not reflected on payslip)

Rent (ZAR)

Water and electricity

Phone Costs (ZAR)

Groceries (ZAR)

Travel costs (ZAR)

Insurance (Vehicle)

Insurance (Other)

School fees (ZAR)

Clothing (ZAR)

Funeral policy

Medical Aid (ZAR)

Account - Furniture (ZAR)

Family Support (ZAR)

Child Support (ZAR)

Bank Loan repayments (ZAR)

Credit card instalments (ZAR)

Motor vehicle instalments (ZAR)

Entertainment (ZAR)

Other (ZAR)

Total

R0.00

Conditions *

Yes, I the undersigned, do hereby confirm that all the information contained in this application for is true and correct and that I have disclosed all material facts

"Please note you may be requested to visit our office to provide original documentation if necessary , you will be contacted if required "

Layout

Signature *

Date *

APPLICATION FORM

Please list your residential address(es) for the past 2 years.

Next of Kin

UNIT

APPLICANT DETAILS

APPLICANT DETAILS

Other Occupants 1

Other Occupants 2

Other Occupants 3

EMPLOYER

(if Self employed state “Self Employed” )

EMPLOYER

(If self employed , leave blank )

INCOME

Income for all occupants

APPLICATION FORM

Please list your residential address(es) for the past 2 years.

Next of Kin

UNIT

APPLICANT DETAILS

APPLICANT DETAILS

Other Occupants 1

Other Occupants 2

Other Occupants 3

EMPLOYER

(if Self employed state “Self Employed” )

EMPLOYER

(If self employed , leave blank )

INCOME

Income for all occupants

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