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Tenancy Details

Property Address *

Intended move-in date


Your Details

Full Name *

Date of Birth *

Phone Number

Mobile Number

Email *

Current Address *

How long have you lived there *

Present Employer *

How long have you been in this employment *


Identification

Drivers license or Passport number *

Version Number

Car / vehicle registration number

Car make and model

Alternative form of ID


Emergency Contact

Name *

Address *

Phone Number

Mobile Number

Email


Current Landlord's Details

If you are currently renting, please provide your landlord's name and contact details below

Name

Phone Number

Mobile Number

Email

May we contact this person for a reference?


References

Please provide two referees that we 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.

Reference 1 Name

Phone

Email

Reference 2 Name

Phone

Email


Signature

I authorise the Landlord/Property Manager to: (1) collect, retain and use this information for the purpose of assessing my creditworthiness; and (2) 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.