Request For Refund And/Or Final Inspection

Stand Number:

Street Address:

First Name:
Surname:

Postal Address:

Tel Number:
Email Address

Please indicate which of the following you are requesting:

APPOINTMENT FOR FINAL INSPECTION & HOA OCCUPATIONAL / AESTHETIC COMPLIANCE	APPOINTMENT FOR FINAL INSPECTION & HOA OCCUPATIONAL / AESTHETIC COMPLIANCE
REFUND OF CONTRACTOR’S DEPOSIT (R6000.00)	REFUND OF CONTRACTOR’S DEPOSIT (R6000.00) I hereby request that the surroundings of my stand be inspected, if found satisfactory, that the Contractor’s Deposit (R6000.00), which I paid to the HOA, be reimbursed to me

NB: Please attach a copy of your Occupational Certificate from Tshwane Local Municipality.

Remarks:

Option 1:

Refund by EFT:

Refund by EFT

Bank Details:

Option 2:

Credit my Levy Account

NOTE: Should there be any outstanding monies on your Levy and Click-On Account, these shall be deducted from the Contractors/Pavement Deposit before the balance is paid out to you.

NB: Please provide a cancelled cheque OR bank statement as proof of banking details.

Click here to upload any supporting documentation, Eg, Proof of Payment, cancelled cheque, bank statement, copy of your Occupational Certificate from Tshwane Local Municipality.

SIGNATURE:

DATE:

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and used properly, lawfully, and openly for the following purpose: Request for Refund and / or Final Inspection Form
We confirm 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).

REQUEST FOR REFUND AND/OR FINAL INSPECTION

HEAD OFFICE

CLUBHOUSE

GOLF CLUB

SECURITY ACCESS OFFICE