Landlord Application Form

Insurance Protection
Landlord Application Form
!
If you take a deposit from your tenant on an Assured Shorthold Tenancy agreement in England
and Wales, you must protect it with a government-authorised tenancy deposit protection scheme.
mydeposits is designed for landlords who want to keep hold of the deposit for the duration of the
tenancy, rather than handing it over to a third party.
With mydeposits:
3 You hold the deposit in your bank account
3 You have the freedom to resolve any issues directly with your tenant
3 We are here to help with any formal disputes
I like to be able to manage the money myself
and have more control over the deposits. I can
return the deposit to the tenants quickly at
the end of their stay which they appreciate.
Mr Popat, mydeposits member since 2008
Notes on how to complete this Application Form
• This Application Form should be completed by all landlords who wish to join the mydeposits Tenancy Deposit Protection Scheme.
Depending on how your letting business operates, you should only fill out the relevant coloured sections as detailed below.
!
•Applicants who run their lettings business in their private name, and own personally the
properties they let, should complete sections A1 and A2 of this form.
•Applicants who run their lettings business in the name of a limited company or partnership,
(which owns the properties to be let) should complete sections B1 and B2 of this form.
•
All applicants should complete sections C and D of the form.
• Applicants who run their business as a letting or managing agent (ie they do not own the properties and act as an agent
for other landlords) should NOT complete this form. Instead, please complete the mydeposits Agent application form.
• All questions must be answered in BLOCK CAPITALS using black ink. We will not accept any application form where
questions are answered incorrectly, left blank or are illegible.
• By signing this application form and paying the fees due, you agree to abide by the Scheme Rules. Any breach of the
Scheme Rules will render your membership invalid and result in deposits not being protected.
• mydeposits Membership cannot be granted without payment of the membership fee. You will not be able to protect any
deposits until you join.
• If you wish to apply using this form, we only accept payment by cheque, made payable to mydeposits. If you wish to pay by
Credit/Debit Card please join online at www.mydeposits.co.uk or call our team on 0333 321 9401.
• Your mydeposits membership will begin as soon as we receive and process your application form. Please allow 5 working
days for us to process and then post your confirmation letter and membership details. If you have not heard from us in
10 working days please contact our team on 0333 321 9401.
• Please note your membership name given on this form must exactly match the name given on the AST agreement. It is a
condition of mydeposits membership that you:
- Read
- Understand
- And agree to abide by The Scheme Rules (a copy of these rules is available to read or download from our website www.mydeposits.co.uk).
• A separate deposit protection fee is required to protect each individual tenant deposit. You can do this online in the members
area, by post or phone.
• To protect a deposit you need to a pay flat-rate deposit protection fee at the beginning of a fixed term AST. This lasts until
the end of the fixed term or if your AST Agreement continues to a Statutory Periodic Tenancy. If you create a new AST
Agreement, even if it is issued to the same Tenant(s) using the same deposit, you must purchase a new protection.
What you will need to complete this form:
• Your contact details
• Your mother’s maiden name
• Your cheque book
• If applicable, your trade organisation/professional body membership number and promotional code
TO BE COMPLETED BY PRIVATE INDIVIDUAL LANDLORDS ONLY
Section A1
Personal Information
Please ensure that all the information in the following section is correct. The information will be used to
create your mydeposits membership.
Single Membership or
J
oint Membership (The membership must be in the name of the person(s)
who owns the property)
Joint Member Details
Q1
Q2
Title
First Name
Last Name
Title
First Name
Last Name
Please state your correspondence address and postcode.
We will send all membership information and postal communications to this address. Please ensure that the
address you provide is your regular correspondence address. We regret that we cannot accept an application for
membership from a landlord who can only provide a PO Box address, OR who resides in the Isle of Man, OR who
resides permanently outside the United Kingdom.
Address
Postcode
Page 2 of 6
Section A1
Q3
Personal Information
continued
Joint Member Details
continued
Please provide us with the following contact details (Please tick your preferred method of communication):
Home Telephone
Work Telephone
Mobile
Fax
Email
Q4
Please provide the following security information. This will be used by the Scheme to perform adequate security
checking should you ever need to contact us by telephone.
Date of Birth:
D D M M Y Y Y Y
Mother’s Maiden Name:
Please provide a memorable word for additional security purposes:
Section A2
General Questions
Guidance Notes: These questions relate to our acceptance criteria and must be answered to the best of your
knowledge. We reserve the right to check the validity of your answers with credit and fraud checking organisations.
We regret that membership of the Scheme will be declined if you provide an adverse response to these questions
or fail to answer them all.
Have you ever been:
Q1
Convicted of (or do you have a hearing pending for) money laundering, fraud
or any other financial crime?
YES
NO
Q2
Refused membership of any other tenancy deposit protection scheme whether
insurance-based or custodial? YES
NO
Q3
Refused a licence to operate a private rented property as required under the
Housing Act 2004?
NB. Proceed to Section C
Page 3 of 6
YES
NO
TO BE COMPLETED BY PRIVATE INDIVIDUAL LANDLORDS ONLY
Section B1
Company Information
The
A.
B.
C.
D.
member as a company landlord must:
Own and let residential property in England and Wales and be named on the AST as the landlord
Be incorporated and registered in the UK and provide the full name and address for service.
Provide the full names, addresses and date of birth for two officers of the company.
Hold and remain accountable for protected deposits.
Q1
Company Name:
Q2
Contact Name:
Q3
Please state your correspondence address and postcode. We will send all membership information and postal
communications to this address. Please ensure that the address you provide is your regular correspondence
address. We regret that we cannot accept an application for membership from a landlord who can only provide a
PO Box address, OR who resides in the Isle of Man, OR who resides permanently outside the United Kingdom.
Address
Postcode
Q4
Company Registration Number (where applicable):
Q5
Address of Registered Office. We regret that we cannot accept an application for membership from a company
that can only provide a PO Box address, OR is registered in the Isle of Man, OR is operated from outside the
United Kingdom.
Address
Postcode
Q6
Please provide us with the following contact details (Please tick your preferred method of communication):
UK Landline Telephone
Work Telephone
Mobile Telephone
Fax
Email
Q6
Page 4 of 6
Please provide the following security information. This will be used by the Scheme to carry out security checks should
you need to contact us by telephone. This must be a memorable word or number at least 8 characters long.
Section B2
Details of Directors and Partners
Guidance Notes: These questions relate to our acceptance criteria and must be answered to the best of your
knowledge. We reserve the right to check the validity of your answers with credit and fraud checking organisations
and to request personal guarantees if applicable. We regret that membership of the Scheme will be declined if you
provide an adverse response to these questions or fail to answer them all.
Has your company, partnership or trading entity, its directors, partners and/or owners ever been:
Q1
Q2
Q3
Convicted of (or do you have a hearing pending for) money laundering, fraud
or any other financial crime?
NO
Refused membership of any other tenancy deposit protection scheme whether
insurance-based or custodial?
YES
NO
Refused a licence to operate a Letting business in England & Wales?
YES
Please provide the full details for two directors and officers for the company.
Title
Date of Birth
First Name
Last Name
D D M M Y Y Y Y
Address
Postcode
Business Title
Title
Date of Birth
Telephone
First Name
Last Name
D D M M Y Y Y Y
Address
Postcode
Business Title
Page 5 of 6
YES
Telephone
NO
TO BE READ AND SIGNED BY ALL APPLICANTS
Section C
Declaration
To the best of my knowledge and belief the information provided in connection with this application, whether
in my own hand or not, is true and I have not withheld any material facts. I understand that non-disclosure or
misrepresentation of relevant facts may entitle the Scheme to void my membership immediately and without appeal.
I have read, understand and accept the Scheme Rules of membership. I agree to abide by the Scheme Rules.
I accept that my signature binds me, my estate and my personal representatives.
Full Name
Signed:
Date:
D D M M Y Y Y Y
Position in Company (if applicable)
To assist us with the effectiveness of our marketing activity please advise us how you heard about mydeposits:
Section D
Joining Fees
The standard price of registering with mydeposits is:
£20.00* (inclusive of VAT)
Certain professional bodies and trade organisations have negotiated discounted joining fees for their members. If you
believe you qualify, please contact your trade organisation for further details. They will advise you of the discounted joining
fee and the Promotion Code that you will need to quote to qualify for the discount. When you have obtained this information
please complete the questions below and return the application form to us with payment of the joining fee by cheque.
Third party discount details (if applicable)
Organisation Name:Membership Number:
NLA Security Code (if applicable):
Promotion Code:
Discounted Membership Fee enclosed (inclusive of VAT):
WARNING - Where a discount has been claimed against a membership fee, failure to provide both a valid Promotion Code and your
Association Membership Number will result in the application being declined. Failure to supply the correct information or payment of an
incorrect amount of your joining fee will result in your application being declined. We reserve the right to check this information against
databases held by your professional body or trade association. Please make all cheques payable to ‘mydeposits’. Your membership will not
be activated until you have received confirmation from us. You will be unable to protect any deposits until your membership has been agreed.
DATA PROTECTION
Communities and Local Government has appointed Tenancy Deposit Solutions Limited T/A mydeposits and/or HFIS plc T/A Hamilton
Fraser Insurance as a Scheme Administrator to act on its behalf to gather and process the information you provide together with
information from other services for the purpose of providing a tenancy deposit scheme as regulated by The Housing Act 2004.
This includes the provision of alternative dispute resolution. For further information, please refer to the full Data Protection Notice at
the end of the Scheme Rules or contact mydeposits on 0333 321 9401 or email [email protected] or write to:
Customer Services Manager, Hamilton Fraser Insurance, 1st Floor, Premiere House, Elstree Way, Borehamwood WD6 1JH.
STATUS
mydeposits is an Appointed Representative of HFIS plc who are authorised and regulated by the Financial Conduct Authority –
Member Number 306513. You can check this information by visiting www.fca.gov.uk/register mydeposits Registered Office: Lumiere
House, Suite 1-3, 1st Floor, Elstree Way, Borehamwood WD6 1JH. Registered in England: 05861648. VAT No. 893 9729 49.
Page 6 of 6
www.mydeposits.co.uk
www.communities.gov.uk
L_INS_LAF_v1_0216_6362
Authorised by
* This is our current joining fee and it is subject to change.
Tenancy Deposit Solutions Limited, trading as mydeposits.
Registered office: Lumiere House, Suite 1-3, 1st Floor, Elstree Way, Borehamwood WD6 1JH.
Registered in England No: 05861648. VAT No. : 893 9729 49
Next Steps:
Please enclose your cheque
and return to:
mydeposits, Premiere House
1st Floor, Elstree Way,
Borehamwood WD6 1JH