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Property Address *
Intended move-in date
Full Name *
Date of Birth *
Current Address *
How long have you lived there *
Present Employer *
How long have you been in this employment *
Drivers license or Passport number *
Car / vehicle registration number
Car make and model
Alternative form of ID
If you are currently renting, please provide your landlord's name and contact details below
May we contact this person for a reference?
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
Reference 2 Name
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.