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💡To expedite your application, please email your latest 3 months’ bank statements to: [email protected]

PERSONAL DETAILS

Email*

Title*

First Name*

Surname*

Mobile Number*

Home Telephone Number

Date of Birth*

ID Number / Passport Number*

Nationality*

Marital Status*

EMPLOYMENT DETAILS

Employer Name*

Work Telephone Number*

Occupation*

Gross Monthly Income (Applicant)*

Gross Monthly Income (Household)

APPLICANT PHYSICAL HOME ADDRESS

Street Address Line 1*

Street Address Line 2*

City/Town*

Postal Code*

Province*

APPLICANT POSTAL ADDRESS

*If different from above

Street Address Line 1

Street Address Line 2

City/Town

Postal Code

PERSONAL REFERENCE #1

First Name*

Surname*

Mobile Number*

Relationship*

PERSONAL REFERENCE #2

First Name*

Surname*

Mobile Number*

Relationship*

product you wish to buy

Product Name*

DECLARATION

I hereby certify that all the information provided in this application form is true and correct. I acknowledge that this information is given to Digifax (Pty) Ltd trading as Digirent for the purpose of assessing my ability to pay the monthly rental under the Rent2Buy facility. I understand that Digirent may investigate my payment history and report information regarding the conduct of my account to credit bureaus and other relevant entities. I understand that Adventure Hub (PTY) LTD trading as Metal Detectors South Africa | MDSA™ is solely the retailer of the products and is not a party to this rental agreement.

Agreement

I have read and accept the above declaration

💡To expedite your application, please email your latest 3 months’ bank statements to: [email protected]

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