Property Details
Property Address
Rent per week

Applicants Details
Applicant's Name *
Date you wish to enter the property
How long do you wish to rent for
Present residential address

If renting, how long at this address?
Why are you leaving?
Have you ever had a Tenancy terminated before?	Yes No
If Yes, give details
Have you ever had money deducted from your bond?	Yes No
If Yes, please give details

Current Telephone Numbers
Home Phone *
Work Phone
Mobile
Email Address *

Residents Details
Number of people intending to reside (including applicant)
Names of people intending to reside (plus date of birth)

Employers Details
Name of current employer (if employed)
How long with this employer?
Phone number of current employer
Address of current employer
Brief details of Previous employment
Other income source for those not currently employed
Total Weekly Income Net
Any additional forms of income

Vehicles
Parking motor vehicles on the property?	Yes No
If yes, state details

Pets
Do you have a pet?	Yes No
What is the pet?

Personal Details
Are you or any other prospective occupant, a smoker?	Yes No
Identification
Date of Birth
Verified by
If you are Under 18 are you married?	Yes No
Name of nearest relative (in Auckland)
Relationship (eg. Father)
Address
Telephone
General Comments
Request Information. This application form asks you to provide personal information and Purpose of collection, The information is being collected on this form so 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 Recipient of Information: The intended recipient of this information is the agent whose name appears at the top of this form or the landlord and Sight Information. We advise you that you have the right to see the information we hold about and Correct Information. To correct that information if it is incorrect and Holding Information. If you do not enter a tenancy agreement with the landlord referred to on this application form, the form will be destroyed but if you sign a tenancy agreement with us we will keep a record of the information you give us. Please Note: Understanding by completing this form you evidence the fact the you are applying to rent a residential house/flat/apartment and 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 Please note: A separate completed application form is required for each person who proposes to enter a tenancy agreement as a tenant.

Referees
I agree to you obtaining other information about me and contacting any of the following referees (please state relation they are to you)
Referee
Phone
Referee
Phone
Referee
Phone

Tenants Declarations, Consents & Agreements
I agree that you may use any of the information on this form to enforce any judgement in respect of the tenancy agreement or in respect of any order against me made by the Tenancy Tribunal and I agree to any of this information being given to another landlord, credit bureau or tenant default database and I agree that if I enter an unconditional agreement to rent residential premises introduced to me through the agent I will pay the agent a fee or commission equal to one week's rent plus GST. I confirm the information in this form is true and correct and that I have read and signed the Cautions under the Privacy Act 1993 and other information on this form before completing the application form itself.
I Agree I Disagree