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PO Box 72-859 Papakura 2244
TENANCY APPLICATION FORM
By signing this application you give permission for all/any information on this form to be used/ discussed to help determine the suitability of the applicant for rental accommodation, this can include a full credit check on all names listed. Also photo id is a requirement. Please be aware that when a deposit has been paid, there are no refunds.
Today's Date :...................................... Preferred move in Date :............................................
Property applying for :.............................................................................................................
Rent: $.............pw Bond :(4 weeks rent) $....................... Admin Fee: $..........................
WINZ form required Yes No
Total move in cost $
Full name of person applying for Tenancy: ...............................................................................
Phone :..................................................... Mobile :.............................................
Wk Phone :........................................................
Occupation or Benefit Type & No.
................................................................................................................................................
Date of Birth / / Drivers Licence Number :........................................................................
(5a)..............................(5b).............................
PHOTO ID MUST BE ATTACHED TYPE OF ID :..................................................................
PHOTO ID ATTACHED YES / NO
Partners Full Name :...................................................................... Date of Birth / /
Occupation or Benefit Type & No. :.................................................
Work No. :..........................................Mobile No ..............................................
Present Address : .................................................................................................................
How long have you lived there : ..............................................................................................
Reason for leaving present address.........................................................................................
Email Address :.................................................................................................
Current Landlords Name :...........................................................
Contact Phone No. :.....................................................................
Written Reference supplied : Yes No
Other Reference supplied : .....................................................................................................
..............................................................................................................................................
Weekly Income (in hand)
Applicant $........................... Partner $............................ Other $...........................
TOTAL $.....................................................
Names of ALL OTHERS including children, and D.O.B. (if adults) & ages (if under 18yrs) who will be living with you
Full Name :................................................................D.O.B / / Occupation :.....................
Full Name :................................................................D.O.B / / Occupation :.....................
Full Name :................................................................D.O.B / / Occupation :.....................
Full Name :................................................................D.O.B / / Occupation :.....................
Full Name :................................................................D.O.B / / Occupation :.....................
Present Employer :.................................................................................................................
Contact Person : ......................................................Phone No.:..............................................
Address : ..............................................................................................................................
How long have you worked there : ..........................................................................................
Credit Reference, Company Name/Person : ............................................................................
Phone Number : ................................................................
Mobile :............................................................................
Credit Reference, Company Name/Person : ............................................................................
PhoneNumber :.................................................................
Mobile :............................................................................
Personal Reference,
Name :....................................................................................................................................
Phone Number :...............................................................
Mobile ............................................................................
Personal Reference,
Name : ...................................................................................................................................
Phone Number : ...........................................................
Mobile :.........................................................................
Do you have a car : Yes No
Reg No. :.....................................Make,Colour & Year……………………………………………....
Do you have any Pets : Yes No
If Yes what kind of Pet:...........................................................................................................
Do you or people who will be living with you smoke : Yes No
If moved in the past two years, where did you live before :
.............................................................................................................................................
Nearest Relative in New Zealand not living with you (next of kin)
Name :...........................................................................................
Relationship : .........................................
Ph : ................................Mobile: ....................................... Wk Ph : ....................................
Address : ...............................................................................................................
NOTE : No Tenancy Agreement should be implied or inferred on the basis of this application form. No Tenancy Agreement will be entered until evidence by payment of a deposit. I understand that if I have provided false information, this may affect my application. I understand that I may be asked to provide a written reference from my current landlord before any tenancy can be entered into.
Privacy Act 1993 Statement
Pursuant to the privacy act 1993 the following is brought to your attention
I/We ................................................the undersigned give HomeStar Rentals Ltd, a privacy waiver giving permission to the company to conduct a full credit check as per requested on my tenanting one of their properties. The information is required so that information can be sought from WINZ, Telecom, Power NZ, Mercury, T.I.N.Z, Veda Advantage, the NZ Police, or any other Companies that are not named in this article by HomeStar Rentals Ltd. The Tenant agrees that should there be any unpaid rental, water rates or damages at the end of the tenancy any debt collection fees or costs for recovering this money may be added to the total debt owing and will be the Debt of the tenant. This clause will then be used by any debt-recovering agency to add their costs to the debt; there-by ensuring your Landlord recovers the amount owed to them. Any failure of rent payments will be acknowledged and there-fore a notice will be served under section 56of the Residential Act and will give you 14 days to remedy the breach of your tenancy agreement.
1. The information in this Tenancy Application form will be made available to the Manager of HomeStar Rentals Ltd, and any person associated with the property you are seeking to rent.
2. The information is being collected and held on database by HomeStar Rentals Ltd.
3. Failure to provide all the information in this form or provision of incorrect information may result in your application being declined.
4. You have rights of access to and corrections of this information held by HomeStar Rentals Ltd and any Credit bureau or tenant default database, in accordance with the Privacy Act.
I have read and understood this form and certify the information to be true and correct and I declare that I am 18 years of age or over.
Signature(s) :...............................................................................................................................................................................
Date :......../....../........
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