Tenancy Application Form - Fisk & Nagle Page 2
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2E. APPLICANT HISTORY
H. CONTACTS / REFERENCES
10.
How long have you lived at your current address?
18.
Please provide a contact in case of Emergency
Surname
Given Name/s
Years
Months
11.
Why are you leaving this address?
Relationship to you
Phone no.
12.
Agent/Landlord details of this property (if applicable)
Name of landlord or agent
19.
Please provide 2 personal references (not related to you)
1. Surname
Given name/s
Landlord/agent’s phone no.
Weekly rent paid
$
Relationship to you
Phone no.
13.
What was your previous residential address?
2. Surname
Given name/s
Postcode
14.
How long did you live at this address?
Relationship to you
Phone no.
Years
Months
I. OTHER INFORMATION
15.
Agent/Landlord details of this property (if applicable)
Name of landlord or agent
20.
Car Registration
Landlord/agent’s phone no.
Weekly rent paid
21.
Please provide details of any pets (Please also include a photo)
Breed / type
Council registration / number
$
Was bond refunded in full?
If not - why not?
Desexed? Y/N
Age
Inside/Outside
1.
F. EMPLOYMENT HISTORY
Desexed? Y/N
Age
Inside/Outside
16.
Please provide your employment details
2.
What is your occupation?
J. PAYMENT DETAILS
Property Rental
What is the nature of your employment?
(FULLTIME/PART TIME/CASUAL)
$
______________
Per week
$
Employer’s name (inc. accountant if self employed or institution if a student)
First payment of rent in advance
$
Rental Bond (4 weeks rent):
Employer’s address
$
Sub Total
Less: Holding deposit (see below)
$
Postcode
Amount payable on signing tenancy agreement
$
(bank cheque or money order only)
Contact name
Phone no.
K.
SIGNATURES & DECLARATION/PRIVACY STATEMENT
I hereby offer to rent the property from the owner under a lease to be prepared by the
Length of employment
Net income?
Agent. Should this application be accepted by the landlord I agree to enter Into a
Residential Tenancy Agreement.
$
Years
Months
I acknowledge that this application is subject to the approval of the owner/landlord. I
declare that all information contained in this application (including the reverse side) is true
17.
Please provide your previous employment details
and correct and given of my own free will. I declare that I have inspected the premises and
Occupation?
am not bankrupt.
I authorise the Agent to obtain personal Information from:
(a) The owner or the Agent of my current or previous residence;
(b) My personal referees and employer/s;
Employer’s name:
(c) Any record listing or database of defaults by tenants;
If I default under a rental agreement, in accordance with current rental legislation, I agree that
the Agent may disclose details of any such default to a tenancy default database, and to
agents/landlords of properties I may apply for in the future
Length of employment
Net income?
(d) Public records, including online identity verification
I am aware that the Agent will use and disclose my personal information in order to:
$
Years
Months
(a) communicate with the owner and select a tenant
(b) prepare lease/tenancy documents
(c) allow tradespeople or equivalent organisations to contact me
Please Note: It is mandatory to provide a copy of tenant ledgers
(d) lodge/claim/transfer to/from a Bond Authority
with you application form or it will be rejected
(e) refer to Tribunals/Courts & Statutory Authorities (where applicable)
(f) refer to collection agents/lawyers (where applicable)
G. PLEASE PROVIDE US WITH 100 POINTS OF ID
(g) complete a credit check with NTD (National Tenancy Database) and / or TRA
Photo ID
50 each
(Trading Reference Australia)
Birth Certificate
10
I am aware that if information is not provided or I do not consent to the uses to which personal
Other ID
20
information is put the Agent cannot provide me with the lease/tenancy of the premises. I am
Last 4 Rent Receipts
50
aware that I may access personal information on the contact details above.
2 Written References
20
Copy of Utilities Bill
10
Signature of Landlord's Agent
Registration Papers
10
Date
Plus 4 weeks of Pay slips, Current Bank Statements & written references from
Signature of Applicant
Landlord or Agent
Date
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