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REGISTERED OWNER/TENANT INFORMATION
(As specified on the title deed/lease agreement)
FIRST NAME
LAST NAME
ADDRESS
ERF:
EMAIL ADDRESS
CELLPHONE NUMBER
APPLICANT INFORMATION
(Complete applicable fields)
LEASE COMMENCEMENT DATE:
LEASE EXPIRY DATE:
FIRST NAME
LAST NAME
IDENTITY/PASSPORT NUMBER:
ASYLUM SEEKER:
YES
NO
PERMIT/VISA NUMBER:
EXPIRY DATE:
OCCUPATION:
GENDER:
- Select -
MALE
FEMALE
RELATION TO REGISTERED OWNER/TENANT:
HOME ADDRESS:
EMAIL ADDRESS:
TELEPHONE NUMBER:
DRIVERS LICENSE:
- Select -
YES
NO
LICENSE NUMBER:
EXPIRY DATE:
VEHICLE MAKE:
VEHICLE MODEL:
REGISTRATION NUMBER:
VEHICLE MAKE:
VEHICLE MODEL:
REGISTRATION NUMBER:
SLEEP IN:
- Select -
YES
NO
DAYS EMPLOYED:
MON
TUE
WED
THUR
FRI
SAT
SUN
In applying for Biometric Access Registration and thereby gaining access to the Estate as defined in the Statutes of the Mooikloof Owners’ Association NPC (“MOA”), I declare that I enter the Estate at my own risk and indemnify the MOA, its directors, employees, contractors and/or consultants against any claim and/or all and any actions of whatsoever nature which may result from my entering and/or residing in the Estate.
I hereby acknowledge receipt of a complete copy of the Mooikloof Owners’ Association NPC statutes and undertake to familiarise myself with the content of this document. By signing this document, I accept that I am a member/tenant of the said Association and would fulfil the terms of the articles of the Association.
I give my consent to the MOA to collect, store and process my personal information.
I give my consent to the MOA to share with the owner my ingress and egress records.
The MOA is committed to protecting your privacy and ensuring that your Personal Information is collected and used properly, lawfully, and openly for the following purpose: Biometric Access Application, Ingress and Egress Records, GloVisitor/GloCMS App.
The MOA confirms that your Personal Information collected will be used and disposed of as is required by the Protection of Personal Information Act No. 4 of 2013 (POPI Act).
An owner must provide the MOA with a copy of the lease agreement for all new/existing tenants. Should a tenant extend the lease period, the variation/extension agreement must also be provided to the MOA in order to extend the tenants biometric access etc.
The Owner of the property hereby agrees and consents that the registered tenant as so specified in the lease agreement may: sign all biometric application forms, documents and other papers as may be required by the MOA for their family members, dependents and/or employees while contractually bound by the lease agreement.
Only an original ID Book / Passport / Driver’s License / Asylum Document / Permit is accepted for Biometric Access Registration.
A copy of the ID Book / Passport / Driver’s License / Asylum Document / Permit must be attached to the application form.
A copy of the applicant’s driver’s license may be requested.
Residents under the age of 18 years (Minors) must provide their learner’s or driver’s license to obtain access through the boom gates.
The cost of the
access registration fee is R50.00
(subject to change without notice).
Photocopies
will be charged at
R5.00 per page
.
Email Address (Send a Copy of Application Form)
I/We hereby agree to the terms set out above
Submit Form
