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 Online Tenancy Application
You MUST view the property from the road before applying.
Property Address: *
Property Manager:
Your available move in date: / /

Your Details (The Applicant):
Name (as per ID): *
Preferred Name:
Date of Birth: *
/ /
IRD No:
Drivers Licence No:
Version No (5B):
Home Phone
+
Work Phone:
+
Mobile Phone:
+
Email: *
Current Address: *
*
Reason for leaving: *
Time at current address: (Y/M) *
/
Previous Address: *
*
Reason for leaving: *
Time at previous address: (Y/M) *
/

No.of people to occupy property.
Adults/Children: * /

Age/s of Children:

Number of vehicles: *
Make/Model Vehicle 1:
Registration:
Make/Model Vehicle 2:
Registration:
Make/Model Vehicle 3:
Registration:
   
Smoker/s: No Yes  
Pets: No Yes If yes, details:

Your Source of Income:
WINZ Client Number:
Benefit Type:
Occupation:
Start date:
Employer:
Employer Address:
   

Spouse/Partner:  
Name (as per ID):
Preferred Name:
Date of Birth:
/ /
WINZ Client Number:
Drivers Licence No:
Version No (5B):
Employer:
Employer Address:

Other adults that will be living at the property:
1. Name (as per ID):
Preferred Name:
Date of Birth:
/ /
WINZ Client Number:
Drivers Licence No:
Version No (5B):
Employer:
Employer Address:
   
2. Name (as per ID):
Preferred Name:
Date of Birth:
/ /
WINZ Client No:
Drivers Licence No:
Version No (5B):
Employer:
Employer Address:

Emergency Contact/Additional Address for Service:
Family member, next of kin or close friend who permanantly resides at their address
Name: *
Relationship to you: *
Address: *
Phone: *
+

References:  
Present Landlord:
Phone:
+
Address of Rental Property:
 
Previous Landlord:
Phone
+
Address of Rental Property:
 
Your Employer/Supervisor:
Phone
+
Partner's Employer/Supervisor:
Phone:
+

Privacy Act 1993 Statement

  1. For the purposes of the Privacy Act 1993:
  2. This application form collects personal information about you.
  3. This information is required to: assess your eligibility as a tenant; and collect information which would be provided to a tenant default database or credit bureau if you enter into a tenancy agreement and fail to comply with the terms of that agreement. (A tenant default database records the names of persons who have been found to breach a tenancy agreement or the Residential Tenancies Act 1986 by the Tenancy Tribunal).
  4. The information in this tenancy application form will, if you enter into a tenancy agreement with us, be held on a database and used by us and the owner of the rented property.
  5. The information will also be made available to credit bureaux or tenant default databases.
  6. If you do not supply all information in this form, you may not be considered as a tenant for any of the properties we administer.
  7. You have the right to see the information we hold about you and to correct that information in accordance with the Privacy Act.
  8. You have the right to see information held about you by any credit bureau or tenant default database and to correct it in accordance with the Privacy Act.

I/we authorise/instruct you to use any address herein provided by me/us for an additional address for service.
I/we consent to you contacting my employer or any person or company named in this application, to confirm, verify, and expand on any information given herein.
I/we consent to you providing the information in this form and details of any proven breach in my tenancy agreement or of the Residential Tenancies Act 1986 to any credit bureau or tenant default databases and acknowledge that the information may then be publicly accessible.
I/we consent to you obtaining a credit report about me/us.
I/we agree that you may use any of the information on this form to enforce any judgment in respect of the tenancy agreement or in respect of any order against me made by the Tenancy Tribunal.
I/we confirm the information in this form is true and correct and that I/we have read and understood all of the above including the Privacy Act 1993 statement, and hereby appoint The Rent Shop Ltd as my / our agent to find accommodation for me / us.

I/we agree:

  1. To pay a non-refundable holding fee of one weeks rent plus GST immediately on acceptance of my/our application.
  2. Within 7 days after the acceptance date, or before receiving the keys to the property, to pay the balance of move in costs and sign the Tenancy Agreement.

NOTE:

  1. This is an application to rent and is subject to the landlord’s approval.
  2. If you do not enter into a tenancy agreement following the completion of this form it may be destroyed.
  3. A separate form may be required for each person who proposes to enter a tenancy agreement.

I have read and accept the terms above above.

 
 
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