Application Form

Are you a homeowner: (required)

We can only help you if are a Homeowner.
YesNo

Do you live in: (required)

We can only help you if you live in within a predetermined area.
GautengEastern CapeFree StateKwaZulu-NatalLimpopoMpumalangaNorthern CapeNorth WestWestern Cape

Market value of property (required)

(required)
* Minimum R250,000

Outstanding bond balance on property (required)

What is your Gross salary (required)

What is your Nett salary (required)

Value of all other debt (Excluding the bond.) (required)

*For example: Credit cards, Personal loans, etc.

Title:(required)

MrDrProfRevMrsMiss

First Name (required)

Surname (required)

ID Number (required)

Employer Name (required)

Employer Telephone

Email Address (required)

Home Number

Mobile Number (required)

House Address (required)

Street number

Street

Province (required)

City (required)

Postal Code

Country

How are you married? (required)

SingleIn Community of PropertyAntenuptial Contract

Is the property jointly owned? (required)

YesNo

Where did you hear about Reality Fund

I confirm the statements on this page true and I consent to my credit bureau profiles being checked. (required)
Yes

If we cannot assist you, would you like us to refer you to an associate company? (required)

YesNo

Today's date (required)