Tenancy Application Form

Please complete the following details to apply for the tenancy at the below address. We require as much information as possible.

The information you provide is for the purpose of applying for this tenancy only and may be used for a credit and reference check. Your privacy is protected under the Privacy Act 1993.

Application Details

Address of the property you are applying for(Required)

Your full name(s)(Required)

Dates of Birth(Required)

Dates of Birth

State number of Children and their Ages(Required)

Address(Required)

Email address(Required)

Telephone numbers(Required)

How long have you lived there?

Why are you leaving this address?

When do you want the tenancy to begin?

If currently renting, please provide landlord/property manager details below

Name(s)

Telephone numbers

Can I contact this person for a reference?

Close Relatives Details

Name of close relative

Address

Relatives telephone numbers

Relationship to you

Source of Income

Employer(s)

Address

Phone number

Length of time with present employer

If receiving WINZ provide benefit number

References

Please provide two referees (including telephone numbers) that we can contact. Referees can be a friend, someone you have worked with, your case manager, your employer or someone from your community who knows you well. One of your referees should be someone who can provide a reference about your credit worthiness. If you have already provided your current landlords details above, one additional referee is enough. Please let these people know we may be contacting them for a reference about you.

Referee 1

Referee 2

Todays date

I hereby appoint you to act as my agent to arrange rental accommodation for me. By introducing me to the premises for which I am applying, should it lead to me taking a tenancy of the same premises, I undertake to pay a deposit, being equivalent to 2 weeks rent not withstanding that you may also be engaged as the management agent by the landlord. I agree to pay the deposit within 2 days of confirming to rent an agreed property from you. If this deposit is not paid within the 2 days, I understand that I have forfeited the property. Once I have paid the deposit, should I change my mind and not want the property, I understand and agree that the deposit is not refundable or transferable and therefore forfeited by me. Should at any stage between now and commencement of the tenancy, the Landlord and/or Letting Agent decide not to let the above property to you, your deposit may be partly or fully refunded depending on the circumstances.

Terms & Conditions(Required)

I Agree

I HAVE READ AND UNDERSTOOD THIS APPLICATION FORM. I AGREE TO THIS INFORMATION BEING USED AS NECESSARY TO OBTAIN PERSONAL REFERENCES AND A CREDIT CHECK. BY SUBMITTING THIS FORM I AGREE TO ALL OF ABOVE CONDITIONS.