Residential Rental Application Form

Residential Rental Application Form

Please complete this application thoroughly and completely to ensure a speedy process and response time!
This form must be used for all applications to enter into a residential rental agreement. For more information about your rights and responsibilities, please visit the Consumer Affairs Victoria (CAV) website at consumer.vic.gov.au or call CAV on 1300 55 81 81.
Apply Code*

3. Number of occupants
Total number of occupants intended to reside on the premises *
[insert total number of occupants]

5. Employment details
Current or most recent employer *
[insert name of current or most recent employer]
Employer address *
[insert employer address]
Net weekly income *
[insert net weekly income]
If not currently employed, date on which most recent employment ended:
[insert most recent date of employment]

6. Financial information
A rental provider or their agent may request no more than two documents from the following list to confirm your capacity to pay the proposed rent:
• Pay slips from current or recent employment
• Bank statement (without transaction details)
• Centrelink payment statements or letters
Please provide one copy of each of the following requested financial documents to verify your ability to pay rent:
Pay slips from current or recent employment*

[Rental provider or their agent to indicate requested financial document]
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Bank statement (without transaction details)*

[Rental provider or their agent to indicate requested financial document]
Cancelof
If you are not receiving regular income, for example you are self-employed, undertake casual employment, freelance or unemployed, please provide details of previous employment or other documents supporting your financial ability to pay rent, such as proof of savings or assets.
Cancelof
Cancelof

7. Verification of identity
A rental provider or their agent can request no more than two identity documents from the following list:
• Driver licence
• Proof of age card (government issued)
• Medicare card
• Australian passport
• Foreign passport and Australian visa
• Birth certificate
• Certificate of Australian citizenship
• Tertiary student identification card
• Centrelink card
• Department of Veterans’ Affairs card
• Utilities bill at current address
• Letter from a government Department addressed to current address

Please provide a copy of each of the following requested documents to verify your identity.
Driver licence*

[Rental provider or their agent to indicate requested identity document]
Cancelof
Utilities bill at current address*

[Rental provider or their agent to indicate requested identity document]
Cancelof
You should discuss with the rental provider or their agent the most suitable method of identity verification if you are unable to provide the requested documents
Cancelof
Cancelof

8. Rental or residential history
Property 1
Current / most recent address:*
[insert current / most recent address]
Postcode*
[insert postcode]
Period of residence at address: *
[insert date you started living at this property and the date you vacated or will vacate the property]
Rental provider / agent name if applicable: *
[insert rental provider / agent name]
Rental provider / agent email if applicable: *
[insert rental provider / agent email address]
Rental provider / agent phone contact details if applicable: *
[insert rental provider / agent phone number]Format: 0000 000 000.
Property 2
Previous address: *
[insert current / most recent address]
Postcode*
[insert postcode]
Period of residence at address: *
[insert date you started living at this property and the date you vacated the property]
Rental provider / agent name if applicable: *
[insert rental provider / agent name]
Rental provider / agent email if applicable: *
[insert rental provider / agent email address]
Rental provider / agent phone contact details if applicable: *
[insert rental provider / agent phone number]Format: 0000 000 000.

9. References
Referee 1
Name:*
[insert referee's name]
Phone:*
Please enter a[insert referee's phone number] valid phone number.Format: 0000 000 000.
Email: *
[insert referee's email address]
Referee's connection to applicant: *
[insert referee's connection to the applicant]
Referee 2
Name:*
[insert referee's name]
Phone:*
Please enter a[insert referee's phone number] valid phone number.Format: 0000 000 000.
Email: *
[insert referee's email address]
Referee's connection to applicant: *
[insert referee's connection to the applicant]

10. Term of rental agreement
Desired lease term (e.g. 6 months, 12 months, 24 months):*
[insert preferred lease term]
Preferred move in date: *

DayMonthYear
[insert preferred move in date]

12. Signature
I understand that my application may not be processed unless all required documents are submitted.
Print name: *
[insert name]
Signature: *

Clear
Date: *

DayMonthYear
[insert date]
Should be Empty:

PART A—GENERAL