Please complete this form to apply for the tenancy at the address below. The information you provide is for applying for this tenancy and may be used for a credit and reference check. We may also search publically available records using the information provided in this form.
Tenancy Details
Property address
Intended length of stay (min 1 month)
Prefered start of tenancy
Applicant Details
*First name
Middle name
*Date of Birth
*Phone Number
*Mobile number
*Current address
*How long have you lived there?
*Please state why you are leaving this address
*Did you live here with anyone else?
*Can we contact them as a reference? please provide contact details
*What is your source of income?
Criminal Convictions
*Do you have any Criminal Convictions or pending court dates?
Please give details if you answered Yes:
Please provide photo identification, such as your drivers license or passport.
Are you a NZ Citizen?
If you are not a NZ Citizen when did you move to New Zealand?
Passport Number
*Drivers license number
*Version no. (if applicable)
NB: Provision of this number is voluntary and will only be used to verify your identity and for carrying out a credit check.
Car/vehicle registration number:
Make and model
Alternative form of ID:
Current Landlord`s Details
If you are currently renting or flatting, please provide your landlord`s name and contact details
*Landlords Name
*Phone number
Mobile phone
*Please tick if I may contact this person for a reference?
Please provide two referees that I can contact. Referees can be a friend, co-worker, your employer or someone who knows you well.
One of your references should be able to provide a reference about your creditworthiness. If you have already provided your current landlord`s details, only one additional referee is needed. Please let these people know I may be contacting them for a reference.
*Reference 1 name
*Relationship to you
*Reference 2 name
*Relationship to you
By submitting this application I authorise the landord/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 another 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)