Pre-tenancy application form
Please complete this form to apply for the tenancy at the address below. The information you provide is for applying for this tenancy and may be used for a credit and reference check.Your privacy is protected under the Privacy Act 1993.
Tenancy details
Property address:
*
i.e. 2 Canon Hill
Commencement of tenancy:
*
-
Month
-
Day
Year
Date
Applicant details
Full Name
*
First Name
Last Name
E-mail
*
Phone Number
-
Area Code
Phone Number
Mobile Number
*
-
Area Code (i.e. 021)
Phone Number
Birth Date
*
Please select a month
January
February
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Month
Please select a day
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Day
Please select a year
2024
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Year
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you lived there?
*
Months or Years
Please state why you are leaving this address:
*
Identification
Please provide photo identification, such as your driver’s licence.
Driver’s licence number:
NB: Provision of this number is voluntary and will only be used to verify your identity and for carrying out a credit check
Version no.
(if applicable)
Alternative form of ID:
Upload a form of ID, i.e., Drivers License or Passport.
*
Browse Files
Cancel
of
Emergency contact
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Mobile Number
*
-
Area Code
Phone Number
Current landlord’s details
If you are currently renting, please provide your landlord’s name and contact details.
Landlord’s name:
*
Phone Number
-
Area Code
Phone Number
Mobile Number
*
-
Area Code
Phone Number
Email
*
example@example.com
May we contact this person for a reference?
*
Yes
No
Personal References
Please provide two referees that I can contact. Referees can be a friend, co-worker, your employer or someone who knows you well.
One of your referees should be able to provide a reference about your creditworthiness. If you have already provided your current landlord’s details, only one additional referee is needed. Please let these people know I may be contacting them for a reference.
Reference #1 Full Name
*
First Name
Last Name
Relationship to Applicant
*
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Reference #2 Full Name
*
First Name
Last Name
Relationship to Applicant
*
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Other Information
Vehicles to be parked on premises
Make/Model/Year/License #
In the past, have you been delinquent in paying rent or other financial obligations? If yes, please explain:
*
In the past, have you failed to perform any obligations of a rental agreement or have you been a defendant in an eviction situation? If yes, please explain:
*
Final Submit
Terms
I authorise the Landlord/Property Manager to:• collect, retain and use this information for the purpose of assessing my creditworthiness and suitability for the tenancy; and• disclose information about me, whether collected from me directly or from any other source, to any other credit provider or any credit reporting agency for the purposes of providing or obtaining a credit report (which will involve the credit reporting agency providing information about me to the Landlord/Property Manager).I understand that the credit reporting agency:• may hold my information on their credit reporting database and use it for providing credit reporting services, and they may disclose my information to their subscribers for the purpose of credit checking or debt collection; and• as part of providing a credit report, may check the Ministry of Justice fines database for any overdue fines I may have.
*
I Agree
Disclaimer
Under the Privacy Act 1993, you have the right to ask for a copy of all information held about you, and have the right to request the correction of any incorrect information.
Date Signed
-
Month
-
Day
Year
Date
Signed
*
Please enter your Full Name
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Submit Application
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