Tenancy Application Form
ADDRESS OF PROPERTY: _________________________________________________________________________
PERSONAL DETAILS
SURNAME: ___________________________________________ MIDDLE INITIAL: ____________ FIRST NAME: _______________________________________
ADDRESS: _________________________________________________ SUBURB: ___________________________________________ STATE: _____________
POST CODE: ______________________ DATE OF BIRTH: __________________________________ EMAIL ADDRESS: _________________________________
PHONE HOME: ___________________________________ PHONE WORK: _______________________________ MOBILE: ______________________________
EMAIL ADDRESS:____________________________________________________________________________________________________________________
EMPLOYMENT DETAILS
CURRENT EMPLOYER: ________________________________________________________________________________________________________________
ADDRESS: _____________________________________________________________________ OCCUPATION: ________________________________________
PERIOD OF EMPLOYMENT: ______________________________ - _______________________________
CONTACT NAME: _____________________________________________________________________ PHONE: ________________________________________
CURRENT TENANCY DETAILS
CURRENT AGENT: ____________________________________________________________________________________________________________________
CONTACT NAME: ________________________________________________________ AGENTS PHONE: _____________________________________________
PREMISES MOST RECENTLY RENTED: ___________________________________________________________________________________________________
PERIOD OF TENANCY: ____________________________________________________ RENT PER WEEK: $ __________________________
REASON FOR VACATING: ______________________________________________________________________________________________________________
PERSON TO BE NOTIFIED IN AN EMERGENCY
NAME OF PERSON NOMINATED: ______________________________________________________ RELATION TO YOU: ________________________________
ADDRESS: ______________________________________ SUBURB: ___________________________________ STATE: _____________ P/CODE: __________
PHONE HOME: _________________________________ PHONE WORK: _______________________________ MOBILE: ________________________________
TENANCY REQUIREMENTS
LEASE COMMENCEMENT DATE: _____________________________________ RENTAL AMOUNT: _______________ LEASE TERM: ______________________
OCCUPANTS: No. of Adults ____________ No. of Children ____________ Ages _____________
DO YOU HAVE ANY PETS: Yes or No
IF YES, WHAT TYPE: _________________________________________________________________________
OTHER PERSONS TO BE NOTED ON LEASE (IF ANY): _________________________________________________
OFFICE USE ONLY
FIRST PAYMENT OF RENT IN ADVANCE (2 weeks)
RESIDENTIAL BOND (4 weeks)
TENANTS SHARE OF R.T.A. FEES (50%)
TOTAL
RESERVATION FEE (1 week)
BALANCE OWING BEFORE OCCUPATION (payable by EFTPOS or bank cheque only)
$ _______________
$ _______________
$ _______________
$ _______________
$ _______________
$ _______________
NOTICE: Section 42A of the Property, Stock and Agents Act 1941 provides that an application to review a statement of claim or itemised account may be made to
the Department Of Fair Trading within 28 days after the statement of claim or itemised account is served on you.
AUTHORITY BY EACH APPLICANT: I authorise the landlord’s agent
(a) to check with my employer, my last or present landlord/agent, and the referees named as to my suitability as a tenant;
(b) to request and received from Estate Agents Co-operative Limited and from other real estate agencies information regarding my previous tenancies; and
(c) If this application is accepted, to furnish a copy of this application to Estate Agents Co-operative Limited for use by it for future referral purposes.
RESERVATION:
In consideration of the above reservation fee paid by the applicant(s) the landlord’s agent acknowledged that:
(1) The premises will not be let during the above period, pending the marking of a residential tenancy agreement: and
(2) If the landlord has not decided to enter into a residential tenancy agreement in the agreed terms for the residential premises concerned during the period, the
whole of the fee will be refunded: and
(3) If the entering into of the residential tenancy agreement is conditional on the landlord carrying out repairs or other work and the landlord does not carry out the
repairs or other work during the specified period, the whole of the fee will be refunded; and
(4) If the applicant(s) decide(s) not to enter into such an agreement, and the premises were not let or otherwise occupied during the period they were reserved the
landlord may retain so much of the fee as is equal to the amount of rent that would have been paid during the period the premises were reserved (based on
the proposed rent) but is required to refund the remainder (if any) of the fee; and
If a residential tenancy agreement is entered into, the fee is to be paid towards rent for the residential premises concerned.
TENANT SIGNATURE
AGENTS SIGNATURE
PRIVACY ACT ACKNOWLEDGEMENT FOR
TENANTS
In accordance with Privacy Principle 1.3 of the Privacy Act we require you to read and sign
this acknowledgment. In order to process a tenancy application a tenancy applicant is
required under the National Privacy Principles of Privacy act to be made aware that an
organisation may access a database. In addition a tenancy applicant is entitled to know
what will happen to their information when it is passed onto an agent.
In accordance with the National Privacy Principles the database member discloses that in
addition to information being supplied to a database company other organisations may
receive information from time to time. Other organisations may include debt collection
agencies, insurance companies, government departments and other landlords or agents.
I the said applicant declare that I give my information correctly to Cripps & Cripps Real
Estate, I further give my permission for my information to be provided to any other
tenancy database for the assessment of my tenancy application. I further give consent to
Cripps & Cripps Real Estate to contact any of my referees provided by myself.
I agree and understand that once a tenancy application has been lodged with a member
of a tenancy database and an inquiry made with tenancy database my information may
be recorded as making an inquiry.
I agree that in the event of a default occurring under a tenancy agreement I give my
permission to the member of a tenancy database to register any of my details or such
breach with a tenancy database. I further agree and understand that a removal of such
information from a database company is subject to the conditions of the Database
Company.
I agree and understand that should I fail to provide the database member with the
information and acknowledgments require the database member may elect not to
proceed with my tenancy application. I agree and understand that a listing with
TRA Tenancy Reference Australia could have an adverse effect on my ability to obtain
future rental accommodation.
___________________________________
Applicant Name
___________________________________
Applicant Signature
___________________
Date