'Residential Tenancy Application Form'

Property Details

Property Address

Street Address^*

Address Line 2^*

City^*

County / State / Region^*

Zip / Postal Code^*

Country^*

I wish to apply to rent the above property for a period of:^* 25 Weeks 52 Weeks

Rent Per Week^*

Bond^*

Requested Commencement Date^*

Number of Adults^*

Number of Children^*

Age/s of Children

Pets?^* Yes No

Type

Breed

Age

Personal Details

Applicant’s Personal Details

First Name^*

Last Name^*

Date of Birth^*

Contact Number^*

Email^*

Driver's Licence Number

Driver's Licence State

Emergency Contact #1

Name^*

Relationship^*

Phone^*

Emergency Contact #2

Name^*

Relationship^*

Phone^*

References

Personal Referee #1

Name^*

Relationship^*

Phone^*

Address^*

Personal Referee #2

Name^*

Relationship^*

Phone^*

Address^*

Other Applicants

If this application is to be considered with other applicants, please provide their names below;

Other Applicants

Rental History

Your previous address #1

Street Address^*

Address Line 2^*

City^*

County / State / Region^*

Zip / Postal Code^*

Country^*

Period of occupancy (year and month)^*

Rent or share of rent per week^*

Reason for leaving^*

Agent / Landlord's contact^*

Your previous address #2

Street Address^*

Address Line 2^*

City^*

County / State / Region^*

Zip / Postal Code^*

Country^*

Period of occupancy (year and month)^*

Rent or share of rent per week^*

Reason for leaving^*

Agent / Landlord's contact^*

Has your tenancy ever been terminated by a landlord or agent?^* Yes No

Are you in debt to another landlord or agent?^* Yes No

Have any deductions ever been made from your rental bond?^* Yes No

Has there been any problems or feedback given at inspections?^* Yes No

If yes to any of the above, please provide details:

Details

Employment

Occupation/Income

Occupation/Position^*

Employment Period^*

Employer^*

Employer Address^*

Contact Person^*

Phone Number^*

Net (after tax) income per week^*

Centrelink payments per week^*

Additional income per week^*

Terms

Terms & Conditions

I confirm that the above information is accurate and correct and can be used to carry out credit checks in relation to renting a property. Conti Business Brokers uses TICA (Default Tenancy Control Pty Ltd) to assess your applications.
Should you be in breach of express or implied provisions of the Tenancies Act or the tenancy agreement, by signing at the of this application, you agree that you will pay the property owners costs incurred in undertaking collection to recover his / her losses.

Privacy statement

I declare that all the information contained in this application is true and correct, and the information is provided of my own free will, and I am not bankrupt. I further authorise the Agency to contact any of the referee’s or references supplied by me in this application for verification of the details provided.
I authorise the Agent to obtain personal information from any record listing or database of defaults by tenants. If I default under a rental agreement, I agree that the Agency may disclose details of any such to default to a tenancy default database, and to agents / landlords of properties I may apply for in the future.
I am aware that the Agent will use and disclose my personal information in order to communicate with the owner and select a tenant, prepare lease / tenancy documents, allow tradespeople or equivalent organisations to contact me, notify relevant Bond authority, refer to Tribunals / Courts and Statutory Authorities, refer to collection Agents / Landlords.
I agree and understand that in the event of this application being rejected by the landlord, there is no requirement for the Agency to disclose to me any reason for rejection.
I agree that after being approved for the property, and all moneys are paid, only then will the keys be provided.

Signature^*

Date^*

^* required fields