| Rental Application

Please can EVERY adult that will be occupying the property submit an application form.

Rental Application

Please complete this form to apply for the tenancy at the address below. The information you provide is for applying for this tenancy and may be used for a credit and reference check. Your privacy is protected under the Privacy Act 1993.

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

Tenancy Details

Property Address:

Commencement of tenancy:

Amount of rent p/wk:

Application Details

Full name: *

Date of birth: *

Phone:

Mobile:

Email: *

Current address:

How long have you lived there? (years & months)

Please state why you are leaving this address? *

Identification

Please provide photo identification, such as your driver's licence.

Driver's licence number:

Version no. (if applicable):

NB: Provision of this number is voluntary and will only be used to verify your identity and for carrying out a credit check.

Car/ vehicle registration number:

Make/ model:

Alternative form of ID:

Pets

Details on pets (If any):

Emergency Contact

Full name:

Phone:

Email:

Mobile:

Address:

Current Landlord's Details

If you are currently renting, please provide your landlord's name and contact details.

Landlord's name:

Phone:

Email:

Mobile:

Income Details

Employer:

Phone:

Approximate income per week:

Approximate income per annum:

References

Please provide two referees that I can contact. Referees can be a friend, co-worker, your employer or someone who knows you well.

One of your referees should be able to provide a reference about your creditworthiness. If you have already provided your current landlord's details, only one additional referee is needed. Please let these people know I may be contacting them for a reference.

Referee name 1:

Phone:

Email:

Reference name 2:

Phone:

Email:

Signature

I authorise the Landlord/ Property Manager to:

Collect, retain and use this information for the purpose of assessing my creditworthiness and suitability for the tenancy; and
Disclose information about me, whether collected from me directly or from any other source, to any other credit provider or any credit reporting agency for the purposes of providing or obtaining a credit report (which will involve the credit reporting agency providing information about me to the Landlord/ Property Manager).

I understand that the credit reporting agency:

May hold my information on their credit reporting database and use it for providing credit reporting services, and they may disclose my information to their subscribers for the purpose of credit checking or debt collection; and
As part of providing a credit report, may check the Ministry of Justice fines database for any overdue fines I may have.

Signed electronically by: *

Date: *

Under the Privacy Act 1993, you have the right to ask for a copy of all the information held about you, and have the right to request the correction of any incorrect information.

What is four minus 2? *