Please fill out all applicable fields below.
Tenancy start date
Property Address
Suburb
Rent per week
Bond
Full Name:
Your Email
After Hours Phone
Business Hours Phone
Mobile Phone
Date of Birth
Name
Relationship
Age range
Do any of you smoke? Yes No
Your current address
Your previous address
Company Name
Contact Person
Phone Number
Have you ever owned a home? Yes No
Your Occupation
Currently Employed With
Length of current employment
What type of accommodation do you require? (e.g. House, flat? No of bedrooms? Garage? etc)
Rental range (weekly)
Do you have pets? Yes No
Drivers License Number
Drivers License State
Closest relative not living with you
Phone number
Additional comments
I authorise that the above information may be used to carry out a credit check on me. I also agree that should I be in breach of any express or implied provision of the tenancy agreement or any provision of the Residential Tenancies Act, that I will pay the Landlord's costs incurred in undertaking collection action to recover his/her losses. Yes No
