Pre-tenancy application form Please complete this form to apply for 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. Your privacy is protected under the Privacy Act 1993. Tenancy details Property address: Commencement of tenancy: Date: / / Applicant details Full name: Phone number: Date of birth: / Mobile phone: Email: Current address: How long have you lived there? Years: Months: Please state why you are leaving this address: Identification Please provide photo identification, such as your driver’s licence or passport. Driver’s licence or passport number: Version no. (if applicable) Car/vehicle registration number: Make and model: Alternative form of ID: Emergency contact Name: Address: Phone number: Email: Mobile phone: / Current landlord’s details If you are currently renting, please provide your landlord’s name and contact details. Landlord’s name: Phone number: Mobile phone: Email: May I contact this person for a reference? Yes / No (Please check) References 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 referees should be able to provide a reference about your credit worthiness. 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. Referee name 1: Phone: Email: Referee name 2: Phone: Email: Signature I authorise the Landlord/Property Manager to: collect, retain and use this information for the purpose of assessing my creditworthiness; and disclose information about me, whether collected from me directly or from any other source, to any other credit provider or any credit reporting agency for the purposes of providing or obtaining a credit reference. Signed by: Date signed: Under the Privacy Act 1993, 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.
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