Atlantic Seaboard

Shop 2, Marine House

Sea Point, Cape Town, 8006
Tel: 021 401 4338
office@sothebysrealty.co.za

I / We. KUTLO MEDUPE

apply to rent a flat/house (“the Premises”) from the Owner/Landlord.

The address of the Premises is Cape Town City Centre, 16 on Bree

DETAILS OF FIRST PERSON APPLYING TO RENT THE PREMISES

Full Name: Kutlo Medupe

ID No: 9601035720081 (copy to be attached); or
Passport No : (copy to be attached)
Date of Birth: 1996/ 01/ 03
Nationality: South African
Marital Status: Single
If Married: In Community of
ANC; Accrual System
Property;
Telephone: 0637474313 (Work) (Fax)
(Home)
(Mobile) 0637474313 kutlomedupeokay@gmail.com
Email address/es:
Address where you currently stay: 101 KATHERINE STREET, SANDOWN, SANDTON, 2031

Postal Address: 101 KATHERINE STREET, SANDOWN, SANDTON, 2031

Are you the Owner of the property where you currently stay? YES / NO

• If No, please give us the following information: NO

Rental Paid:
• How long have you rented there: 24 MONTHS
• Name of Rental Agent / Landlord: MR CEDRIC
• Office number: 081 471 2090
• Mobile: 081 471 2090
• Email address/es:

Lew Geffen Sotheby’s International Realty Atlantic Seaboard is an independently owned and operated franchise business of
Atlantic Seaboard Properties (Pty) Ltd. Reg No.: 2018/587662/07 under sub-license from Geffen International Realty Franchises (Pty) Ltd.
Director: Marc David Leon
 Atlantic Seaboard
Shop 2, Marine House
Sea Point, Cape Town, 8006
Tel: 021 401 4338
office@sothebysrealty.co.za

DETAILS OF FIRST PERSON APPLYING TO RENT THE PREMISES

BANKING DETAILS:
Bank: FNB (copy of 3 months bank statements)
Branch & Code: 250655
Account number: 63059530725
Type of Account: EASY ACCOUNT

EMPLOYMENT DETAILS:
Self-employed: YES / NO
Occupation:
Current Employer:
Employer's address:
Telephone contact number:
Period of employment:
NO
SOFTWARE DEVELOPER
MAZOLINE (PTY) LTD
85 ST GEORGES, CAPE TOWN CBD, CAPE TOWN, 8001
021 007 4703/ 068 388 7540
2 YEARS AND 4 MONTHS

AFFORDABILITY DETAILS:
Net monthly salary (after deductions & tax): R54,354.55 (copy of payslip attached)
Current monthly expenses: R30,600.00

Lew Geffen Sotheby’s International Realty Atlantic Seaboard is an independently owned and operated franchise business of
Atlantic Seaboard Properties (Pty) Ltd. Reg No.: 2018/587662/07 under sub-license from Geffen International Realty Franchises (Pty) Ltd.
Director: Marc David Leon
 Atlantic Seaboard
Shop 2, Marine House
Sea Point, Cape Town, 8006
Tel: 021 401 4338
office@sothebysrealty.co.za

DETAILS OF SECOND PERSON APPLYING TO RENT THE PREMISES

Full Name:
ID No: (copy to be attached); or
Passport No : (copy to be attached)
Date of Birth:

DETAILS OF SECOND PERSON APPLYING TO RENT THE PREMISES

Nationality:
Marital Status:
If Married: In Community of Property; ANC; Accrual System
Telephone:
(Work) (Fax)
(Home)
(Mobile) Email address/es:
Address where you currently stay:

Postal Address:

Are you the Owner of the property where you currently stay? YES / NO

• If No, please give us the following information:

Rental Paid:
• How long have you rented there:
• Name of Rental Agent / Landlord:
• Office number:
• Mobile:
• Email address/es:

BANKING DETAILS:
Bank: (copy of bank statements)
Branch & Code:
Account number:
Type of Account:

Lew Geffen Sotheby’s International Realty Atlantic Seaboard is an independently owned and operated franchise business of
Atlantic Seaboard Properties (Pty) Ltd. Reg No.: 2018/587662/07 under sub-license from Geffen International Realty Franchises (Pty) Ltd.
Director: Marc David Leon
 Atlantic Seaboard
Shop 2, Marine House
Sea Point, Cape Town, 8006
Tel: 021 401 4338
office@sothebysrealty.co.za

DETAILS OF SECOND PERSON APPLYING TO RENT THE PREMISES EMPLOYMENT DETAILS:

EMPLOYMENT DETAILS:

Self-employed: YES / NO
Occupation:
Current Employer:
Employer's address:
Period of employment:

AFFORDABILITY DETAILS:
(copy of payslip
Net monthly salary (after deductions & tax):
attached)
Current monthly expenses:

GENERAL DETAILS:

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

Number of adults: 1
Number of children: 0
Children’s ages: 1 ;2 ;3 ;4
Names of Schools attended by
children:
Number Pets owned: ; Type:

Number of vehicles at Premises:

1. Type: Registration
2. Type: Registration
3. Type: Registration

Lew Geffen Sotheby’s International Realty Atlantic Seaboard is an independently owned and operated franchise business of
Atlantic Seaboard Properties (Pty) Ltd. Reg No.: 2018/587662/07 under sub-license from Geffen International Realty Franchises (Pty) Ltd.
Director: Marc David Leon
 Atlantic Seaboard
Shop 2, Marine House
Sea Point, Cape Town, 8006
Tel: 021 401 4338
office@sothebysrealty.co.za

GENERAL DETAILS:

Have you (or both of you) ever had any judgments / defaults granted NO Yes / No
against you?
If Yes, please give details:

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.

The applicant is aware that it may take up to 48 hours to verify all the information which will then be provided
to the landlord for his approval of the applicant, which is beyond the agents control. I am aware that the agent
will be providing copies of my credit report/s, payslips and bank statements to the landlord as per the
application process.

An agreement of lease will be presented to the applicant for signature and is then to be signed and returned.
Signature by the Landlord shall constitute acceptance of the agreement under the terms as set out in the lease.
The below amounts to be invoiced shall be payable on issuing of invoice.

LEW GEFFEN SOTHEBYS INTERNATIONAL REALTY ATLANTIC SEABOARD

DECLARATION REGARDING PRIVACY OF YOUR PERSONAL INFORMATION

In assisting with and facilitating this mandate and performing our responsibilities in terms of the mandate, we are
required to collect and process (including the sharing thereof, as necessary) certain of your personal information.
We respect and protect the personal information that we collect from you as is required in terms of the Protection
of Personal Information Act 4 of 2013. Read our Privacy Policy on our website at www.sothebysrealty.co.za for
more details.

Would you like to be added to our contact list for purposes of receiving information in respect of your
property, the area, news, and listings?

Yes No please tick appropriate box

Deposit: R
Lease fee: R 1500.00 ex-VAT
Pro-rata rent: R
1st Month rent: R
Total: R

Lew Geffen Sotheby’s International Realty Atlantic Seaboard is an independently owned and operated franchise business of
Atlantic Seaboard Properties (Pty) Ltd. Reg No.: 2018/587662/07 under sub-license from Geffen International Realty Franchises (Pty) Ltd.
Director: Marc David Leon
 Atlantic Seaboard
Shop 2, Marine House
Sea Point, Cape Town, 8006
Tel: 021 401 4338
office@sothebysrealty.co.za

SUPPORTING DOCUMENTS TO BE ATTACHED WITH THIS APPLICATION

First Person Second Person

RSA ID Document / Passport RSA ID Document / Passport

Proof of current address Proof of current address
3 Month’s Payslip 3 Month’s Payslip
3 Month’s bank statements 3 Month’s bank statements

I/We agree and allow the Landlord or Agent at all times to:

1. contact, request and obtain information from any credit provider (or potential credit provider) or
registered credit bureau that may be necessary to assess my/our behaviour, profile, payment
patterns, indebtedness, whereabouts, and creditworthiness;

2. furnish information concerning the behaviour, profile, payment patterns, indebtedness,

whereabouts, and creditworthiness of me/us to any registered credit bureau or to any credit
provider (or potential credit provider) seeking a trade reference regarding my/our dealings with
the Landlord.

Signed by the Applicant at on this the. 27 day of. JULY 20 23

APPLICANT

Signed by the Second

on this the day of 20
Applicant at

SECOND APPLICANT

(SIGNATURES REQUIRED OF BOTH HUSBAND & WIFE, OR PERSONS SHARING) Ver-July 21

Lew Geffen Sotheby’s International Realty Atlantic Seaboard is an independently owned and operated franchise business of
Atlantic Seaboard Properties (Pty) Ltd. Reg No.: 2018/587662/07 under sub-license from Geffen International Realty Franchises (Pty) Ltd.
Director: Marc David Leon