Application Form

    CUSTOMER DETAIL (to be invoiced)
    Customer
    Billing Detail
    Phone
    Cell
    Email
    Contact Person
    Vat Reg No
    PROPERTY OWNER
    Is the property owned by a person
    or other legal entity?
    If it is a legael entity, please
    state if this is a trust,closed corporation etc.
    If the ownership is a legal entity,
    please provide a resolution for authority to
    sign on behalf of the legal entity (power of attorney).
    Name of Company/Trust/CC
    Reg No
    Owners Name
    Identity Number
    Property Owner Postal Address & Code
    Property Owner Physical Address
    Property Owner Phone
    Property Owner Cell
    Property Owner Email
    PROPERTY DETAILS
    Stand No and Suburb(Town)
    Street Address & Postal Code
    Local Authority(Municipality)
    Nature of Project (Select one of options)
    Is the Original building older than 60 years?
    Are any telephone poles affected YESNO
    Any trees affected
    Is any underground municipality electrical connections affected or any electrical overhead wire within a radius of 3 meter from proposed building