Property Tenancy Application Form

In Terms of the Privacy Act 1993 you are given notice that:

1. Requests information: This application asks you to provide personal information.
2. Purpose of Collection: The information being collected on this form by the landlord/rental manager can check the information and be able to assess whether you would be the best applicant on merit for the tenancy and we are also obliged to inquire whether you are a minor and,
3. Recipient of information: The intended recipient of this information is Geral Harbinson Real Estate Ltd whose name appears on the bottom of this form or the landlord,
4. Sight Information: We advise that you have the right to see the information we hold about you, and
5. Correct Information: To correct that information if it is not correct, and
6. Holding Information: If you do not enter a tenancy agreement with the landlord referred to on this application form, the application form will be destroyed but if you sign a tenancy agreement with Gerald Harbinson Real Estate Ltd we will keep a record of the information you have given us.
7. Other Information drawn to your attention: Understanding: By completing this form you evidence the fact that you are applying to rent a residential house/flat/apartment and,
8. You are further advised that: if you do not supply all the information requested in this form you may not be considered as the best applicant on merit for a specific property or other properties available for rent, and
9. Please note: A seperate completed application form is required for each person who proposes to enter a tenancy agreement as a tenant.
By ticking this box you agree to all of the above
Date:(required)

Rental Property

Property Address:
Rent per Week:
Preferred Move in Date:
Length of Tenancy:

Application Details

Full Name:(required)
Current Address:(required)
How long at this address?(required)
Home Ph:(required)
Work Ph:
Mobile:
Email:(required)
Date of Birth:(required)
If under the age of 18, are you married?
Passport Number:(required)
Drivers License Number:(required)

Occupancy Details

Do you have a pet?
If yes, what sort of pet?
Are you or any prospective tenant a smoker?
Will you be parking a motor vehicle on the property?
If yes, how many?
Number of people intending to reside in the property (including applicant):(required)
Full names of people intending to reside in the property:(required)

Current Rental Details

If renting at current address, rent paid per week:
Why are you leaving?
Name of Property Management/Agent/Landlord:
Phone:
Mobile:
Email:

Previous Rental Details (if any)

Landlord (Property Manager/Agent):
Phone:
Address of Property:
Period of rental:
Have you ever had a tenancy terminated before?
If yes, give details:

Employment Details

Name of Employer:(required)
Occupation:(required)
Length of Employment:(required)
Employment Contact Name:(required)
Phone Number:(required)

Previous employment if current employment is less than 12 months

Employer:
Phone Number:
Employer:
Phone Number:
Employer:
Phone Number:

Details of Nearest Relative

Name:(required)
Address:(required)
Relationship:(required)
Phone Number:(required)

Proof of Identification

Please send us a copy of either your Drivers License or Passport, either through the mail, email, or using the upload box below.
Copy of Drivers License or Passport

Tenants Declarations, Consents and Agreements

I agree to you obtaining other information about me and contacting any of the following referees:
Name:(required)
Phone Number:(required)
Name:
Phone Number:
Name:
Phone Number:
I agree that the landlord may use this information for any of the following:
(a) To carry out any or all credit checks
(b) To enforce any judgement in respect of the tenancy agreement or in respect of any order made against me by the Tribunal
(c) To provide further information to another landlord or organisation
I further agree that if I enter into an agreement to rent a residential property introduced by Gerald Harbinson Real Estate Ltd, I will Pay Gerald Harbinson Real Estate Ltd a fee of one weeks rent (plus GST), and if required, to pay all costs of any collection including disbursements.
I confirm that the details and information are true and correct and that I have read and signed the Cautions under the Privacy Act 1993 together with any other information on this form before completing the application.
By ticking this box you agree to all of the above
Date:(required)

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