Residential Tenancy Application (Page 6 of 7) in pdf

PLEASE COMPLETE CREDIT CARD DETAILS BELOW

One (1) week’s rent will be charged to your credit card as a

holding deposit, upon approval of application.

Credit Card:

Please tick to indicate: □ VISA □ Bankcard □ Mastercard

Card No: _______________________________________________

Cardholder Name ____________________

Expiry Date ____/____

Amount Paid $ ____________

Signature ______________________

Direct Credit & Internet payments:

DEFT PAYMENT SYSTEM DETAILS PROVIDED

NOTE: Credit card details will only be processed upon application approval.

A Free Service –

Connecting Your Utilities Has

Never Been Easier!

connectnow is a simple and convenient time saving service assisting you to connect your Electricity, Gas,

Phone, Internet and Pay-TV to a choice of Australia’s leading providers. connectnow can also assist with

discounted quotes for removalists, van/truck hire, cleaning services and security monitoring.

No longer do you need to call each service provider individually, wait on hold and repeatedly give your

personal details. We take care of it all for you – with the one phone call.

Simply sign below and a connectnow representative will make all reasonable efforts to contact you within

one working day of receiving an application.

Declaration:

I consent to connectnow Pty Ltd A.C.N. 79 097 398 662 arranging for the connection of the nominated home services and to providing information

contained in this application to the service providers. I agree that neither connectnow nor the Agent accepts liability for loss caused by delay in, or

failure to connect/disconnect or provide the nominated services. The service will be activated according to the applicable regulations, service

provider time frames and terms & conditions once the client has agreed to use the chosen service provider. I authorise the obtaining of a National

Metering Identifier on my address to obtain supply details. It is the responsibility of the Tenant to ensure that the Main Electricity Switch is in the “Off

Position” between 7am & 7pm on the day connection is required and that there is easy access to the property. While the connectnow service is

FREE, standard service provider connection fees and charges still apply. You pay NO extra charges

as a result of using the connectnow service. I acknowledge that the terms and conditions of the service provider bind me and that after hours

connections may incur additional service fees from service providers. I acknowledge that connectnow will be paid a fee by the service provider and

will be paying a fee to the Agent for the service being provided to me. Note: Connection of your utilities will only be initiated once a representative

has discussed your connection with you and obtained your consent to the terms and conditions of the relevant utility service provider(s).

Please Call Me

Yes

Signed:………………………………………………………………………….…………..Date……./………/………..

Document: TAF – PM

Revision: 5

Date: 18 March 2015

Page 6 of 6

W:Property ManagementBlank FormsNew Blank Forms – PMTENANCY Application Form V5