Tenant Income Assessment Information Form
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1Tenant Income Assessment Information
This section must be completed and signed by each person over 18 years and over (one form per person).
In the past 12 months from the date of your application:
1. Were you employed at any time?
Yes
No
If YES, list the company name and dates you worked at each job below.
You must provide your most recent 3 consecutive payslips for each job.
Company
Dates From
Dates From
2. Were you self-employed at any time?
Yes
No
If YES, you must provide a letter from your accountant stating GROSS (before
tax) incomeearned and a personal Notice of Assessment or Tax Return from
the most recent financial year.
3. If you are studying, did you receive any payments from a parent/guardian?
Yes
No
If YES, you must provide a signed letter from your parent/guardian stating
the total amount provided per week/per month.
4. Did you receive any payments from Centrelink?
Yes
No
If YES, you must provide your latest Centrelink statement and payment history.
5. Did you receive income from any other sources?
Yes
No
If YES, please list details below and provide evidence of GROSS (before tax)
payments.
I acknowledge upon signing this document that I have disclosed all income sources for the last 12 months
from the date of my application and that all information is true and correct.
I agree that by signing my signature electronically, I accept to be bound to this declaration and any terms and conditions mentioned in this agreement.
DATE
X
YOUR SIGNATURE (see instructions page for details)
Please attach all required documents (as listed above) with your application.
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Parent category: Business