Application Form for a long stay HMO_KoalaRooms

GENERAL PERSONAL INFORMATION

Full Name

First NameLast Name

Nationality:

Date of Birth:

E-mail

example@example.com

Phone Number

Area CodePhone Number

Contact in case of emergency:

Vehicle registration No. colour and mark (obligatory, if you have one):

Residential Address (including full postcode, country)where you can, including after you have left this accommodation, always be reached eventually (this might be parents, etc)

Street Address

Street Address Line 2

CityCountry

Postal / Zip Code

REFERENCE CONTACTS

Your previous address (with contact details to your previous landlords/agent for reference):

Street Address

Street Address Line 2

CityCountry

Postal / Zip Code

Full Name of the previous landlord

First NameLast Name

Phone Nr of the previous landlord

Area CodePhone Number

E-mail of the previous landlord

example@example.com

Time at the previous property, rent paid and the reason you left

To my previous Landlord/ agent: I hereby authorise you to respond to any enquiry received from JBL Property Group and its divisions and to provide to them details of how I have conducted my tenancy, including my payment history and condition of the property. Type your name and surname below:

Employment details with contact details to your work manager for reference

Employer name and address (obligatory, if you are employed):

Full Name of your manager

First NameLast Name

Phone number of your manager

Area CodePhone Number

E-mail of your manager

example@example.com

Time employed, job position, basic income (obligatory, if you are employed):

To My Employer: I hereby authorise you to respond to any enquiry received from JBL Property Group and its divisions and to provide to them confirmation of my salary/income and any other particulars of information they request in connection to this application. I confirm that I will be responsible for any charges raised by you in connection to the provision of this reference.

Financial Details:

1. Do you have any loans / mortgages? If yes, please provide details below:

2. Have you claimed any housing benefit at any address during the last three year? If so, please specify:

3. Have you ever been in arrears of payment? YES / NO

4. Have you ever been evicted? YES / NO

5. Have you got a criminal conviction? YES / NO

6. Are you on bail? YES / No

CONSENTS

Arrival Date

Date

Departure Date

Date

How many people?

Which Property are you applying for?

Which room?

Rent Payment Frequency

Do you require bedding (extra fee applies)

Bank Account Details for deposit refund:

How did you hear about us?

Other

Right to rent share code for the landlord to check (for foreigners):

ID SCAN UPLOAD

Last payslip confirming your employment and income (obligatory, if you are employed):

By my signature I declare that all the information given about me and other people above &/or overleaf is true and complete. I understand and accept that you will rely on all this information in deciding whether to enter a rental contract with me. I authorize you &/or your agent(s) to verify the above information.

Signature