Residential Tenancy Application Form Page 3
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46. Current Situation
10. Current Employment Details
(Must provide proof of
income)
Are you the;
Owner
Tenant
Employment Address;
How long have you lived at your current address?
Years
Months
Suburb;
Post Code;
Name of Landlord/Agent (If applicable);
Contact Name;
Phone Number;
Length at current employment;
Years;
Months;
Rent paid per month; $
Rent paid per week; $
Net Income $
Per Annum, $
Per Week $
Per Month
Reason for leaving;
11. Previous Employment Details
Occupation;
Was bond repaid in full?
Yes
No, If No, please specify
Employers Name;
Employment Address;
Suburb;
Post Code;
7. Previous Rental History
Employer Phone Number;
Were you the;
Owner
Tenant
Contact Name;
Previous Address;
Length at previous employment;
Years;
Months;
Suburb;
Post Code;
Net Income; $
Per Annum, $
Per Week $
Per Month
How long have you lived at your previous address?
Years
Months
12. Personal Referees
1. Reference name;
Name of Landlord/Managing Agent/Selling Agent;
Occupation;
Phone Number;
Relationship;
Phone;
Rent Paid per month;
2. Reference name;
Reason for leaving;
Occupation;
Relationship;
Phone;
Was bond repaid in full?
Yes
No, If No, please specify
13. If Student, please complete the following
Place of Study;
8. Other Information
Income;
Number of persons occupying property;
Adults;
Children;
OFFICE USE ONLY
NTD Check
Yes/No
Current Tenancy
Please specify the ages of any children;
_______________
Defaults
Date/Time
______________
_______________
Judgements
Contact
Do you have pets?
Yes
No. If Yes, please specify;
_______________
________________
Comments
Rental
________________
Are you a smoker?
Yes
No. If Yes, inside or outside?
Property
Previous Tenancy
Current Employment
9. Next Kin
________________
_______________
Date/Time
Date/Time
_________________
_______________
Contact
Contact
Name;
Relationship;
______
__________
_______________
Rent
PPTY
Comments
Address;
Ph;
Landlord Approved YES/NO
Date ____/____/_______
Mobile;
Other;
14. How did you find out about this property? (Please Tick)
RENT LIST
LOCAL PAPER
FOR LEASE BOARD
our website
other internet site
OTHER:______________________
15. Declaration
I acknowledge that this is an application to lease this property and that my
I authorise the Agent to obtain details of my credit worthiness from, the owner or
application is subject to the owner’s approval and the availability of the premises
Agent of my current or previous residence, my personal referees, any record,
on the due date. I hereby offer to rent the property from the owner under a lease
listing or database of defaults by tenants.
If I default under a rental agreement, the
to be prepared by the Agent pursuant to the Residential Tenancies Act 1997.
Agent may disclose details of any such default to any person whom the Agent
I acknowledge that this application is subject to approval from the
reasonably considers has an interest receiving such information.
owner/landlord.
I declare that all information contained in this application
(including the reverse side) is true and correct and given of my own free will. I declare
that I have inspected the premises and am not bankrupt.
Signed:
Date
/
/
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