Residential Application Form Mayfield Real Estate (Page 3 of 3) in pdf

EMPLOYMENT (please provide a copy of 2 current pay slips with application)

Current employer

Occupation/ Job position

Length of Employment

Full time, Part Time, Casual?

Contact Name

Contact Phone no.

Weekly income

CENTRELINK BENEFITS (please provide a copy of Centrelink benefits with application)

Do you receive Centrelink benefits? (circle)

Will you receive rent assistance?

YES/NO

per week

YES/NO

per week

Will the bond be government assisted?

YES/NO

2 PERSONAL OR BUISNESS REFERENCES (NOT RELATIVES)

Name

Occupation

Phone no.

Name

Occupation

Phone no.

EMERGENCY CONTACT/ NEXT OF KIN

Name

Relationship

Phone no.

Address

I CONFIRM THE FOLLOWING:

.During my inspection of this property I found it to be in a reasonably clean condition. Yes/No (circle one)

2. If “No” I believe the following items should be attended to prior to the commencement of my tenancy. I acknowledge that these items are subject to the landlord‟s

approval.

_____________________________________________________________________________________________________________________

3. I acknowledge that this is an application to rent this property and that my application is subject to the landlords approval.

4. I consent to the information provided in this application being verified and a reference check on a national databases being undertaken.

PRIVACY STATMENT

I hereby offer to rent the property from the owner under a lease prepared by the Agent. Should this application be accepted by the landlord I

agree to enter into a Residential Tenancy Agreement. I acknowledge that this property is offered subject to the owners approval and no action

shall be taken by the applicant against the landlord and the Agent should any circumstances arise whereby the property is not available for occu-

pation on the due date. I declare that all information contained in the application and any attachments is true and correct and given if my own free

will. I declare that I am not bankrupt. If I default under a rental agreement, I agree that the Agent may disclose details of such a default to a ten-

ancy default database, and to Agents/Landlords of properties I may apply for in future.

I authorise the Agent to obtain personal information from:

(a)

The owner or Agents of my current or previous residence

(b)

My personal referees and employer/s

(c)

Any record listing or database or defaults by tenants

I am aware that the Agent will use and disclose any personal information in order to:

(a)

Communicate with Owner and select a tenant

(b)