Rental Application Form & Available Rental List Page 2
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397 The Strand
Ph 07 307 7274
Tenancy Application
Whakatane 3120 Fax 07 307 7379
Email
info@xrealty.co.nz
Personal Details
First Name(s) _______________________________________ Surname__________________________________________________
Previous Name/Other names used _________________________________________ _____________________________________
Date of Birth __________________________
Photo ID (Copy Attached) __________________
Car Reg ________________
Current Address ______________________________________________________________________________________________
_______________________________________________________________________________________________________________
Phone Home ______________________________________ Work ____________________________________________________
Mobile ____________________________________________ Email ____________________________________________________
Occupation ________________________________________ Employer _______________________________________________
Are you a WINZ Beneficiary?
No
Yes
If yes, WINZ Client number
______________________________
Do you have Pets ?
No
Yes
If yes, list the number / type of pets you have:
_______________________________________________________________________________________________________________
How long have you lived at your current property?__________________________
Are you the
Owner
Tenant
Reason for leaving current address: _____________________________________________________________________________
Please show all previous addresses you have lived at in the last 2 years (complete on back if necessary)
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
Emergency Contact - Name / Address / Phone (IE : Next of Kin – Not Living with you)
_______________________________________________________________________________________________________________
References
We require 3 credit and 2 landlord references. Please provide names and contact details of those able to provide a
reference in support of your application. (Eg:Current and past landlords /Employer/Credit Agency)
DO NOT include family members:
Name
Contact/Phone
Type of ref (Landlord/Credit etc)
_____________________________________________________________________________________________________
_____
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
Property requirements
Type of Property:
House
Unit / Flat
Apartment
Preferred Area:
Whakatane
Ohope
Other____________________________
Other requirements, please state (eg Number of bedrooms / Garaging / Fencing / Furnished etc)
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Preferred Start Date: ______________________
Preferred Tenancy
Short Term
Long Term
Maximum Rent per week you will pay $_____________________
Number of intended occupants: Adults _________ Children _______ (show children’s ages) _______________
Names of all intended adult occupants:________________________________________________________________
_______________________________________________________________
***Every occupant over 18 years old must complete
Please read and sign the back of this form
……
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