National Rental Affordability Scheme Declaration Form

National Rental Affordability Scheme
Declaration Form
This declaration form is to be signed by the prospective tenant and witnessed by the NRAS
tenancy manager prior to commencing a lease under the National Rental Affordability Scheme
(NRAS) in Queensland.
The NRAS tenancy manager is required to retain the original declaration form for audit purposes
and forward a copy to the Department of Housing and Public Works.
Important Information
•
You must be eligible for NRAS at the time of your application and at the time of being offered
housing by the NRAS tenancy manager. You will be required to provide proof of identity and
income evidence confirming that you are still eligible for the scheme prior to being given a
tenancy.
•
You are required to retain documentation to verify your household asset position and
residency status during the lease period (see table below of evidence you should keep to
verify your household asset positions). You may be subject to an audit process
which will assess your eligibility under the Queensland Government NRAS criteria.
•
Accommodation made available through the National Rental Affordability Scheme is not
social housing. The Department of Housing and Public Works has no involvement in the
ownership of properties, selection of tenants or management of tenancies under NRAS and
cannot take responsibility for tenancy outcomes.
Evidence of your household assets include:
•
Centrelink/Department of Veterans’ Affairs Income and Assets
Statement
•
Copies of banks, building society or credit union statements showing
money in accounts
•
Statements from financial institutions showing total sum of financial
investments held in shares, bonds, debentures, friendly society bonds,
property trusts and any other trusts or managed investments
•
Evidence detailing overseas pensions
•
Compensation payouts or lump sum payout documentation
•
Written statement from superannuation company showing the total
amount in super fund or investment, including annuities (for applicants
who have reached preservation age).
Current household asset limits can be found at www.Housing and Public
Works.qld.gov.au/housing
National Rental Affordability Scheme Queensland
Prospective Tenant Declaration Form VS1 200912
1
Personal information privacy notice
The Department of Housing and Public Works has collected personal information on your application
form to provide you with housing assistance in connection with the National Rental Affordability
Scheme. To assist you with your housing needs and services, relevant personal information related to
your eligibility for the Scheme, will be disclosed to: tenancy managers of National Rental Affordability
Scheme properties, partner agencies, service providers, agencies authorised by legislative provisions,
and local governments and non-governmental agencies that will provide you with housing and/or
support services. Limited personal information may be used for housing related research, policy or
planning functions. Unless authorised or required by law, your personal information will not be passed
on to any other third party without your consent. More information about the department’s privacy
policy is available on the department’s website.
Declarations
I understand:
•
that accommodation made through the National Rental Affordability Scheme is not social
housing. The Department of Housing and Public Works has no involvement in the ownership
of properties, allocations to tenants or management of tenancies under the scheme, and
hence does not take responsibility for tenancy outcomes
•
the instructions and Privacy Notice on this form
•
that all or part of my personal information provided in my NRAS application has been given to
non-government agencies to assist in referring my application to National Rental Affordability
Scheme tenancy managers
•
that this form will be used by the Department of Housing and Public Works to verify that my
National Rental Affordability Scheme application was true and correct
•
that I may become ineligible for National Rental Affordability Scheme assistance if changes
occur to any of my, or members of my household’s circumstances and/or incomes and/or
assets detailed in my application
•
that at the time of signing any residential tenancy agreement with an approved tenancy
manager under the National Rental Affordability Scheme, I must produce proof of identity and
income details that verify I am still eligible for the scheme
•
that I will commit an offence and be liable to a penalty under the Housing Act 2003 if I
knowingly provide to the Department of Housing and Public Works false or misleading
information that may influence decisions about eligibility for housing services and may make
my application invalid.
I agree to be bound by the Privacy Notice and Declarations.
I declare to the best of my knowledge, the information I have provided on this form and in conjunction
with my NRAS application is true and correct.
Name of applicant
Conditional Approval Number
Signed by the applicant
Date
/
/
/
/
Full name of witness
Position
Signature
Date
National Rental Affordability Scheme Queensland
Prospective Tenant Declaration Form VS1 200912
2