Rental Application Form

 

  1. Agent's Details

 

LJ Hooker Bellerive

 

Address: Shop 1, 31 Cambridge Road, Bellerive TAS 7018

Phone no: 03 6244 8555

Fax no: 03 6244 8855

Email: bellerive@ljh.com.au

 

 

 2. Property Details                                                                          

 

Address ________________________________________________________

 

Suburb __________________________________  Postcode _____________

 

Electricity Meter No ___________________________

 

Lease Term   ___________Years     ____________Months

 

Date Property is to be occupied            /            /

 

Number of other Applicants to Occupy the Property

 

Adults ________________  Children _________________

 

 

 3. Personal Details                                                                          

 

Title _____ First Name  ___________________________ Initial ________

 

Last Name ___________________________________________________

 

Date of Birth          /            /                       Age (Years / Months) ___________

 

Drivers Licence Number ________________

 

State of Issue Alternate ID (eg passport)  __________________  No ________________

 

Pension Type (if applicable)  ___________________ No ____________________

 

Please provide contact details:

 

Home Ph  __________________________ Mobile Ph __________________________

 

Email _________________________________________________________________

 

Occupation ____________________________ Work No ________________________

 

Current Address _________________________________________________________

 

Suburb   ______________________________ Postcode ________________________

 

 

 4. Emergency Contact                                                                    

 

Please provide an emergency contact not residing with you:

 

First Name __________________________ Surname ___________________________

 

Relationship  ________________________  Phone No __________________________

 

Address ________________________________________________________________

 

Suburb _________________________________ Postcode _______________________

 

 

 5. Payment Details                                                                          

 

Property Rental:  $ ___________ Per Week or $ ____________ Per Month

 

First Payment of rent in advance $_________________________________

 

Rental Bond (1 Month Rent)   $ ___________________________________

 

Sub Total  $ ___________________________________________________

 

 

 6. Utility Connections                      

                                               

Phone:      1300 554 323

Fax:           1300 889 598

Email:        info@connectnow.com.au

          Internet:    www.connectnow.com.au

 

A Free Service - Connecting Your

Utilities Has Never Been Easier!    

 

Connectnow is a simple and convenient time saving  service  assisting with your Telephone, Electricity & Gas and water connections to some of Australia’s leading providers. connectnow also provide a range of additional services to compliment your household utilities, such as Internet &Pay TV.

This  is a value-added service independent of your  tenancy application - you are not obligated to use connectnow.

If you would like Connectnow to contact you to discuss any of the above services please tick the box and a  connectnow representative will make all reasonable efforts to contact you within one working day of receiving an application. If we are unable to contact you within this period please contact connectnow on 1300 859

181 to ensure connection can be completed by your requested date.

It is the responsibility of the Tenant to ensure that the Main Electricity Switch is in the “Off Position” between 7am & 7pm on the day connection is required and that there is easy access to the property.

While  the Connectnow service is FREE, standard  service provider connection fees and charges still apply.   You pay NO extra charges as a result of using the connectnow service.

 

Please Contact Me   YES/NO

 

 

  7. Declaration     

                                                                             

A)

I acknowledge that this is an application to lease this property and that my application is subject to the  owner’s approval and the availability of the premises on the due date.  I hereby offer to rent the property from the owner under a lease to be prepared by the Agent  pursuant to the Residential Tenancies Act 1997.

 

I acknowledge that I will be required to pay rental in advance and a rental bond,   and   that   this    application   is   subject   to   approval   from   the owner/landlord.   I declare that all information contained  in this application (including the reverse side) is true and correct and given of my own free will. I declare that I have inspected the premises and am not bankrupt.

 

I  authorise the Agent to obtain details of my credit  worthiness from, the owner or Agent of my current or previous residence, my personal referees, any record,  listing or database of defaults by tenants.   If I default  under a rental agreement, the Agent may disclose details of any such default to any person whom the Agent reasonably considers has an interest receiving such information.

 

B)

If section 6 is complete please note

Connection   of your utilities will only be initiated once a  representative has discussed your details  with  you  and  obtained  your  consent  to  the  terms  and  conditions  of  supply  of  the relevant  utility  service  provider(s).  The  privacy  of  our  customers  is  of  vital  importance  to Connectnow.

 

I consent to the collection of my personal information by Connectnow Pty Ltd ACN 79 097 398

662  for the purposes of arranging for the connection and or  disconnection of the nominated moving and connections services and related services, and to providing my personal information contained in this application to the relevant service providers, in accordance with Connectnow’s Privacy    Policy (which is available for my inspection at    www.connectnow.com.au/ljh) Connectnow  and  those  service  providers  may  contact  me  from  time  to  time  (including  by electronic means) to let me know about new or existing products or services. I understand that I can  contact  Connectnow at any time if I do not want to receive that  information  from Connectnow or if I want to update my personal information. I agree that neither Connectnow nor the Agent accepts liability for loss caused by delay in, or failure to connect/disconnect or provide  the  nominated  services.   The service will be activated according to the  applicable regulations, service provider time frames, terms and conditions once agreeing to use the chosen service provider. I authorise the obtaining of a National Metering Identifier and or a Metering Installation Registration Number  on my residential address to obtain supply details. It is the responsibility of the customer/homeowner to ensure that the electricity main switch is in the ‘Off Position’ for the required timeframe on the day of connection and that there is easy access to the meters. I acknowledge that the terms and conditions of the service provider bind me and that  after  hours  connections  may  incur additional service fees from service providers. I acknowledge that Connectnow may be paid a fee by the service provider and may pay a fee to the Agent in respect of the provision of the service provided to me by Connectnow.

 

Signed: ______________________________    Date           /           /

 

 

 8. Applicant History   

 

How long have you lived at your current address? _______years and _______ months

 

Name of Landlord/Agent (if applicable)_______________________________________

 

Phone No _______________________________________________________

 

Rent paid per month $ _____________________________________________

 

Reason for leaving ________________________________________________

 

Was Bond paid in full?     YES/NO

 

If No, please specify why: __________________________________________

 

________________________________________________________________

 

What was your previous residential address:
 

________________________________________________________________

 

Suburb: ___________________________________ Postcode: _____________

 

How long did you live at your previous address: _______years and _______months

 

Name of Landlord/Agent (if applicable) _____________________________________

 

Phone No ____________________________________________________________

 

Rent paid per month $___________________________________________________

 

Reason for leaving ______________________________________________________

 

Was bond paid in full?  YES/NO

 

 

If No, please specify why: __________________________________________

 

________________________________________________________________

 

 

9. Employment Details

 

Occupation ______________________________________________________

 

Employer's Name _________________________________________________

 

Employment Address______________________________________________

 

Suburb ____________________________________ Postcode _____________

 

Employer's Phone No ______________________________________________

 

Contact Name ____________________________________________________

 

Length at current employment ___________ years and __________ months

 

Net income $______________per week or $_______________ per month

 

 

10. Previous Employment Details

 

Occupation ______________________________________________________  

 

Employer's Name _________________________________________________

 

Employment Address ______________________________________________

 

Suburb _____________________________________ Postcode ____________

 

Employer Phone No _______________________________________________

 

Contact Name ____________________________________________________

 

Length at previous employment ___________ years and __________ months

 

Net income $ ______________per week or $_______________per month

 

                                       

 11. Social Security Benefits

 

 Type ___________________________________________________________

 

  $ ____________________ per week or $ ____________________per month

 

 

 12. If Student, please complete the following                           

 

 Place of Study________________________________________________

 

 Course being undertaken _______________________________________

 

 Course Length ________________________________________________

 

 Enrolment Number _____________________________________________

  Parents Name ______________________________ Ph ______________________

 

  Campus Contact ____________________________ Ph ______________________

  Course Co-ordinator _________________________  Ph ______________________

 

   Income _____________________________________________________________

   Parents Address Overseas _____________________________________________

 

 

  13. Other information                                                 

 

  Car Registration ______________________________________________

 

  Do you have pets? YES/NO

  

  If Yes, please specify: __________________________________________

 

  _____________________________________________________________

 

  14. Personal Referees                                                                  

 

  1. Reference name _____________________________________________

 

  Occupation ___________________________________________________

 

  Relationship _______________________ Phone No __________________

 

  Notes ________________________________________________________

 

  _____________________________________________________________

 

  _____________________________________________________________

 

  2. Reference name _____________________________________________

 

  Occupation ___________________________________________________

 

  Relationship ________________________ Phone No _________________

 

  Notes ________________________________________________________

 

  ______________________________________________________________

 

  ______________________________________________________________                               

 

 15. Office Use Only                                                                       

 

Lease Start Date                /                   /

 

Car Space/Garage

 

Landlord’s Name

 

Lease to be signed on

 

Signed:                                                                                     Date         /           /

DISCLAIMER/AUTHORITY

I the said applicant do solemnly and sincerely declare that the information contained in this Application is true and correct and that all of the information was given of my own free will. I further authorise the letting agent to contact and conduct any enquiries and/or search with regard to the information and references supplied in this Application.

 

I the said applicant do solemnly and sincerely declare that I am over 18 years of age and eligible to enter into this agreement.

 

I the said applicant do solemnly and sincerely declare:

1. I have inspected the property at: ...................................................................................................
2. I have of my own accord decided that I wish to rent the aforementioned property commencing ....../....../...... for a period of ....... months.
3. I have been informed, understood and agree that the rental for the aforesaid property is to be $ ............ per week and that this rental is within my means for support.
4. I have been informed, understand and agree that the rental for the said property is to be paid fortnightly in advance at all times.
5. I have been informed, understand and agree that the bond (x4 weeks rent) for the aforesaid property will be $ ....... and I further agree and undertake to pay the said bond on or before signing the tenancy agreement.
6. I understand and agree that should the full amount of the bond not be paid by the signing of the tenancy agreement, I authorise the letting agent to apply all or part of the subsequent rental payments to be apportioned to finalizing of the rental bond for the aforesaid property.
7. I understand and agree that the acceptance of my Application is subject to a satisfactory report being obtained from information supplied on the Tenancy Application submitted by me.

EACH APPLICANT  MUST ACHIEVE A MINIMUM OF 100 POINTS
Last 4 Rent Receipts	50 Points
Drivers License	40 Points
Photo Identification	40 Points
Copy of Birth Certificate	30 Points
Passport	30 Points
Medicare/Healthcare Card	30 Points
Current Registration Papers	10 Points
Previous Bank Statement	10 Points
Previous Telstra Account	10 Points
Previous Aurora Account	10 Points

8. I understand and agree that should there be a requirement to commence proceedings for recovery of rent, repairs and/or damage to the aforesaid property during the term or at the expiration of the Tenancy Agreement all costs associated with these proceedings shall be recoverable by me.
9. I have been informed, understand and agree that should this Application not be accepted, the agent is not required or obligated to disclose why or supply any reason for the rejection of this Application.
10. I have been informed, understand and agree to pay bond and 2 weeks rent in advance by cash or bank cheque prior to receiving the keys on the day of occupation.
11. If your Residential Tenancy Application is approved you will be required to pay at least one week of the nominated rent as a holding deposit for the aforementioned property. The holding deposit guarantees you against the property being leased to anyone else.

 

PRIVACY ACT ACKNOWLEDGMENT

In accordance with Section 18n(1)(b) of the Privacy Act I authorise you to give this information to and obtain information from all credit providers and references named in this application. I understand this can include information about my credit worthiness, credit standing, credit history or credit capacity. I understand this information may be used to assess my application.

 

PRIVACY ACT 1988 – COLLECTION NOTICE

The personal information the prospective tenant provides in this application or that which is collected from other sources is necessary for the agent to verify the Applicant’s identity, to process and evaluate the application and to manage the tenancy.

 

The personal information collected about the Applicant in this application may be disclosed during the course of the tenancy for the purpose for which it was collected, to other parties, third parties, including the Landlord, referees, financial institutions, tradespeople, other agents, third party operators of tenancy reference databases and other third parties as required by law. Information already held on tenancy reference databases may also be disclosed to the Agent and/or Landlord. The Agent may also disclose information to other parties on the Internet.

 

If the Applicant enters into a Residential Tenancy Agreement and if the Applicant fails to comply with their obligations under the Agreement, that fact and other relevant personal information collected about the Applicant during the course of the tenancy may also be disclosed to other parties, including those referred to above.

 

The Agent will only disclose information in this way to other parties to achieve the purpose specified above or as otherwise allowed under the Privacy Act 1988.

 

If the Applicant would like to access his/her personal information held by the Agent, they can do so by contacting the Agent at the address and contact numbers contained in this Application. The Applicant can also correct this information if it is inaccurate, incomplete or out of date. 

 

IF THE INFORMATION IS NOT PROVIDED, THE AGENT MAY NOT BE ABLE TO PROCESS THE APPLICATION AND MANAGE THE TENANCY.

 

APPLICANT NAME: ..................................................................................................

 

APPLICANT SIGNATURE: .........................................................   DATE: ...../...../.....