Tenant Application Form Page 2
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6Time at this Address
Years
Months
Gross Annual Income
£
Status: Home Owner-Mortgage
Renting
Living with Relatives
Marital Status: Single
Married
Other
Telephone Number
Mobile
Email
Smoker
YES
NO
Pets
YES
NO
IMPORTANT - ADVERSE CREDIT HISTORY
Do you have any County Court Judgements, Court Decrees, Bankruptcy, Administration Orders,
Individual Voluntary Arrangements, or any other adverse credit history whether settled or not?
*
YES
NO
If yes, please give details at end of form in Relevant Information/Notes/Additional Information
section
Please note that failure to disclose information relating to adverse credit history may result in
your application being declined.
Do you Have a Criminal Record
YES
NO
If yes please give details and any relevant
*
information/notes at end of form.
Any Previous Evictions
YES
NO
If yes please give details and any relevant
*
information/notes at end of form.
Are you Disabled
YES
NO
If yes please give details and any relevant
*
information/notes at end of form.
Do you Intend to Seek Benefit
YES
NO
If yes please give details and any relevant
Assistance with Rent Payments
*
information/notes at end of form.
Additional Residents (sharers) on this Tenancy:
Age
Full Name of Additional Tenants
Share of Rent
Relationship to You
*
Please provide this information for these additional tenants. – Smokers, Pets, Debt Problems,
Evictions, Disabilities at any relevant information/notes at end of form.
Your Current Landlord or Agent Details
Landlord or Agents Full
Name and Address Including
Postcode
Telephone
Mobile
Email
Why are you Leaving your
Current Accommodation?
Previous Address/s Details
(Up to the Last 6 Years)
Previous Address 1 Including
Postcode
Page 2 of 6
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