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    Claim Form For Private Rental of Property: 1. Details of Landlord/ Agency

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    kentdeproducer003
    The document is a claim form for private rental of property by students. It collects information about the student such as name, student number, and address of rented property. It also collects information about the landlord/agency such as name, address, and contact details. The landlord must sign to confirm the information and agreement.

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    Claim Form For Private Rental of Property: 1. Details of Landlord/ Agency

    Uploaded by

    kentdeproducer003
    7 views2 pages
    The document is a claim form for private rental of property by students. It collects information about the student such as name, student number, and address of rented property. It also collects information about the landlord/agency such as name, address, and contact details. The landlord must sign to confirm the information and agreement.

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    a57e7eab-f5c7-4597-9b4c-24fdc57e99a8 (3)

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    The document is a claim form for private rental of property by students. It collects information about the student such as name, student number, and address of rented property. It also collects information about the landlord/agency such as name, address, and contact details. The landlord must sign to confirm the information and agreement.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    7 views2 pages

    Claim Form For Private Rental of Property: 1. Details of Landlord/ Agency

    Uploaded by

    kentdeproducer003
    The document is a claim form for private rental of property by students. It collects information about the student such as name, student number, and address of rented property. It also collects information about the landlord/agency such as name, address, and contact details. The landlord must sign to confirm the information and agreement.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    LS 139.

    CLAIM FORM FOR PRIVATE RENTAL OF PROPERTY

    PARTICULARS OF THE TENANT (STUDENT)

    Surname and initials


    Student number Months claimed: From To
    Address of
    premises/room/flat
    occupied by the
    student

    Postal Code

    PARTICULARS OF LANDLORD/AGENCY

    1. DETAILS OF LANDLORD/ AGENCY


    Name
    Address

    Postal Code Contact telephone number: Code Number


    Surname and initials of duly authorised person
    Contact telephone number Code Number
    Rental amount per month R

    Date stamped by
    agency / / 2021

    Page 1 of 2
    2. In the case of PRIVATE NEGOTIATIONS LS 139.3
    The landlord of the rented property is: (Mark the appropriate choice with an “X”)
    The owner/Leasehold owner The site permit holder The Residential permit holder
    Title deed details Site permit details Residential permit details

    Details of Landlord
    Surname Initials
    Identity number
    Certified ID document of the Landlord must be attached to this claim form
    Residential address

    Postal Code Contact telephone number: Code Number


    Rental amount per month R

    I, _____________________________________________(surname and name in block letters), hereby confirm that the information in this
    document is correct, and written notice will be given to the University in case of the cancellation/alteration of the agreement. To my knowledge,
    the student is the sole occupant of the above-mentioned premises.

    Signature of Landlord Date signed

    Signature of the Student Date signed

    FOR OFFICE USE


    TO BE COMPLETED BY THE DULY AUTHORISED PERSON OF THE APPLICABLE TRANSITIONAL COUNCIL IF RENTAL OF
    ACOMMODATION IS NOT VIA A REGISTERED AGENCY BUT VIA PRIVATE NEGOTIATIONS
    I certify that the information supplied on this form has been verified and is a true reflection of the information possessed by the Transitional
    Council - Housing Division:
    Place Date Time
    Official of council: Surname Initial
    Contact telephone number Code Number
    Information correct Information incorrect Reason for choice (if applicable):
    Comment:

    Signature:
    Official of
    Council

    Date verified
    and signed / / 2021

    Page 2 of 2

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