Application for rental housing

Application for rental housing

Manawatū Community Trust (Charitable Trust CC32454)
Please complete this form to apply for a tenancy with Manawatū Community Trust (MCT). The information you provide is collected for the purpose of this tenancy application and may be used for a credit and reference check. Your privacy is protected under the Privacy Act 2020.
Tenancy details
Property address (if known):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred commencement date of tenancy:

MonthDayYear
Date
Applicant details
How many people will be living in your household?*

OneTwo
Full name: *

First NameLast Name
Known As*
Date of Birth*
Home Phone Number

Area CodePhone Number
Cell Phone Number*

Area CodePhone Number
Email*
example@example.com
What is your present address?*

Street Address

Street Address Line 2

CityRegion / Rohe

Post Code
How long have you lived there? *
Years and Months
Please state why you are leaving your current address: *
Please state your connection to Feilding? *
A New Zealand citizen, or permanent resident of New Zealand?*

YesNo
Do you receive superannuation or a benefit for a permanent disability?*

Supported LivingSuperannuationOther
How much is your average weekly income after tax? *
Supply Identification*

Drivers LicencePassportOther
Please itemise and disclose the value of all of your assets *
(e.g., cash, investments, house or other property, Trust, vehicles, and any other assets over $5,000)
Identification
Please provide photo identification, such as your driver’s licence. *

Cancelof
Driver’s licence number
Alternative form of ID (if you do not have a driver’s licence):
Do you have a car?*

YesNo
Car registration number*
Name of your Employer / Case Manager
Housing Requirements
Do you have any pets?*

YesNo
Pet type*

CatDogOther
Please specify your pet type*
Are there any special considerations we should know about (you or your household)? Eg. Wheelchair access.*

Health/medical conditionDisabilityOtherNone
Please provide details*
Do you smoke?

YesNo
Current landlord’s details (Referee 1)

If you are currently renting, please provide your landlord’s name and contact details.
Landlord’s name*

First NameLast Name
Landlord’s phone number*

Area CodePhone Number
Landlord’s mobile phone*

Area CodePhone Number
Address of property

Street Address

Street Address Line 2

CityRegion / Rohe

Post Code
Landlord’s email: *
example@example.com
May MCT contact this person for a reference (please tick one)?*

YesNo
References
Have you been a tenant with Manawatū Community Trust before?*

YesNo
Have you ever lived in Kāinga Ora or Community Housing before?*

YesNo
Please provide two written references and provide the contact details for these below.
Previous landlord (Referee 2)
Previous landlord (Referee 2)

First NameLast Name
Phone number (Referee 2)*

Area CodePhone Number
Phone number (Referee 3)*

Area CodePhone Number
Someone that can provide a reference about your character (Referee 3)
Email (Referee 2)*
example@example.com
Email (Referee 3)*
example@example.com
Address of property

Street Address

Street Address Line 2

CityRegion / Rohe

Post Code
Signature
Please read the following information before you sign:

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/We declare that the information contained in this application is true and correct and my signature below applies to all the information*

Yes
I/We declare that I meet both of the eligibility criteria specified in this application.*

Yes
Signature of applicant (1)*
Signature of applicant (2)
Under the Privacy Act 2020, 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.
Should be Empty:

Application for rental housing

Tenancy details

Applicant details

Identification

Housing Requirements

Current landlord’s details (Referee 1)

References

Signature