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.
Tenancy Details
Property address
Commencement of tenancy
Applicant Details
*Full name
Date of Birth
Phone Number
Mobile number
Current address
How long have you lived there?
Please state why you are leaving this address
Please provide photo identification, such as your drivers license.
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.
Alternative form of ID:
Current Landlord`s Details
If you are currently renting, 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
Reference 2 name
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)
By submitting this application, I understand that the credit reporting agency:
- may hold my information on their credit reporting database and use it for providing credit reporting services, and they may disclose my information to their subscribers for the purpose of credit checking or debt collection; and
- as part of providing a credit report, may check the Ministry of Justice fines database for any overdue fines I may have.
Under the Privacy Act 2020, you have the right to ask for a copy of all information held about you, and have the right to request the correction of any incorrect information.