Tenancy Application Form

This information is required for the purpose of assessing your eligibility as a tenant for the property you have applied for. One form should be completed for every intending adult tenant.

Property applying for
House Number:*
Street Name:*
Suburb:*
If selected, preferred commencement date at this address:*
Date Format: DD slash MM slash YYYY
Your Details
Your Name*
First Last
Current Address:*
Mobile Phone:*
Email Address:*
Current Landlord's Name:*
Current Landlord's Phone Number:*
Current Landlord's Email Address*
Reason for Leaving:
Adults
One form should be completed for every intending adult tenant.
Children
Any Pets?
If yes, please state breed.
Are you a Smoker?
- Yes
- No
Car Registration:
Type/Model:
Proof of your current address:
Accepted file types: jpg, jpeg, pdf.
Please upload a copy of a recent Power/Phone account. JPG or PDF
Have you ever been convicted of a criminal offence?
- Yes
- No
If yes, please state details:
Employment
Current Employer Name:*
Employers Phone Number:*
Time with Employer:
Job Title and Description:
If you are currently receiving your income from Work & Income New Zealand please provide details.
Benefit Type:
Customer Number:
Identification
A copy of identification is required. Suitable ID: Photo Drivers Licence, Passport, WINZ Customer ID, Photo Credit Card
Date of Birth:*
Verified with:*
Driver's Licence Number:
If using driver's licence.
Driver's Licence Version:
If using drivers licence.
Proof of identification:
Accepted file types: jpg, jpeg, pdf.
Please upload a copy of your proof of identity. JPG or PDF
References
No references can be family or friends. Most recent landlords as referees.
1. Second most recent Landlord's Name*
First Last
Phone:*
Email:*
Rental Property Address:*
2. Third most recent Landlord's Name*
First Last
Phone:*
Email:*
Rental Property Address:*
3. Employer Reference
Name of workplace referee and position:
Phone:
Email:
Next of Kin
Please provide two Next of Kin details (not living with you).
1. Next of Kin
Name*
First Last
Phone:*
Email:
Address:
2. Next of Kin
Name
First Last
Phone:
Email:
Address:
Privacy Act 1993 Statement
This application form collects personal information about you. It is important for you to know why this information is collected. This information is required for the purpose of:-
- Assessing your eligibility as a tenant;
- Collecting information which may be provided to a tenant default database and/or credit bureau if you enter into a tenancy agreement and fail to comply with the terms of that agreement;
- Being retained within our office for your tenancy and seven years following;
- Failure to supply all the information in this form means you may not be considered for the applied tenancy.
- You have a right to see the information held about you by any credit bureau or tenant default database and to correct that information in accordance with the Privacy Act 1993.
Acceptance
1. I consent to you checking my references and credit checking including using the online Tenancy Information New Zealand (TINZ) database to check references and any associated and available databases.
2. I consent to you providing the information in this form and details of any proven breach of my tenancy agreement or of the Residential Tenancies Act 1986 to any credit bureau or tenant default database.
3. I acknowledge that the information may then be made publicly available through credit bureau or tenant default databases if I have given anyone my authority to do checks on these credit bureaux or tenant default databases or their checks otherwise conforms to the terms of the Credit Reporting Privacy Code 2004.
4. I agree that you may use any of the information on this application form to enforce any judgment in respect of the Tenancy Agreement or in respect of any order against me by the Tenancy Tribunal.
5. I agree that an identification photo and an assessment regarding my fulfilment of basic tenant responsibilities may be added to an internet based tenant reference website. This assessment will be regarding:
  - payment of rent;
  - keeping the dwelling and grounds tidy;
  - being considerate towards neighbours;
  - keeping and leaving the dwelling and grounds tidy;
  - if declined a tenancy - for any reason;
  - any verbal or physical threats;
  - any illegal use or manufacture of drugs within the tenancy.
6. I agree that if I am declined this tenancy for reasons of a poor credit history or adverse Tenancy Tribunal Orders that have been made against me, I am aware that this may be placed on a tenancy database.
7. I confirm the information in this form is true and correct and that I have read the Privacy Act 1993 Statement as stated above.
Privacy Statement and Acceptance
This application form collects personal information about you. It is important for you to know why this information is collected. This information is required for the purpose of:- Assessing your eligibility as a tenant; - Collecting information which may be provided to a tenant default database and/or credit bureau if you enter into a tenancy agreement and fail to comply with the terms of that agreement; - Being retained within our office for your tenancy and seven years following; - Failure to supply all the information in this form means you may not be considered for the applied tenancy. - You have a right to see the information held about you by any credit bureau or tenant default database and to correct that information in accordance with the Privacy Act 1993. Acceptance 1.I consent to you checking my references and credit checking including using the online Tenancy Information New Zealand (TINZ) database to check references and any associated and available databases. 2. I consent to you providing the information in this form and details of any proven breach of my tenancy agreement or of the Residential Tenancies Act 1986 to any credit bureau or tenant default database. 3. I acknowledge that the information may then be made publicly available through credit bureau or tenant default databases if I have given anyone my authority to do checks on these credit bureaux or tenant default databases or their checks otherwise conforms to the terms of the Credit Reporting Privacy Code 2004. 4. I agree that you may use any of the information on this application form to enforce any judgment in respect of the Tenancy Agreement or in respect of any order against me by the Tenancy Tribunal. 5. I agree that an identification photo and an assessment regarding my fulfilment of basic tenant responsibilities may be added to an internet based tenant reference website. This assessment will be regarding: - payment of rent; - keeping the dwelling and grounds tidy; - being considerate towards neighbours; - keeping and leaving the dwelling and grounds tidy; - if declined a tenancy - for any reason; any verbal or physical threats; any illegal use or manufacture of drugs within the tenancy. 6. I agree that if I am declined this tenancy for reasons of a poor credit history or adverse Tenancy Tribunal Orders that have been made against me, I am aware that this may be placed on a tenancy database. 7. I confirm the information in this form is true and correct and that I have read the Privacy Act 1993 Statement as stated above.
I agree to the terms listed above*
Date*
Date Format: DD slash MM slash YYYY
Please enter the text below:

Tenancy Application Form

Property applying for

Your Details

Employment

Identification

References

Next of Kin

Privacy Act 1993 Statement

Acceptance

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