Rental Application
Siwicki Real Estate has a legal obligation to our landlords to ensure that all prospective tenants can
fulfil the requirement of the residential tenancy agreement.
Please ensure all information and 100 points of ID is supplied. Each applicant must complete a
separate application and if any occupants are over 18, they must also fill out an application.
Applications cannot be processed unless pages 3 and 4 have been signed.
Proposed Property:
Applicants Details.
Full Name:
DOB:
Marital Status: Married/Single/Divorced/Separated/De facto
Number of Children:
Ages:
Maiden Name (if Married), or any other name used in the past:
Drivers Licence Number:
State:
Vehicle Registration:
Contact Information:
Home number:
Mobile:
Work:
Email:
Current Address:
Rent:
Date Commenced:
Reason For Leaving:
Agent/Landlord:
Phone:
Do you expect a full bond refund? Y /N If no, why?
Previous Address:
Rent:
Date Commenced:
Date Ceased:
Reason For Leaving:
Agent/Landlord:
Phone:
Do you receive a full bond refund? Y /N If no, why?
Previous Address:
Rent:
Date Commenced:
Reason For Leaving:
Agent/Landlord:
Do you receive a full bond refund? Y /N If no, why?
Phone:
Date Ceased:
Current employment/Income:
Occupation:
Date Commenced:
Employer:
Weekly Income (After Tax):
Address:
Phone:
If less than 6 months, please give details of previous employment
Occupation:
Date Commenced:
Employer:
Weekly Income (After Tax):
Address:
Phone:
Centrelink Payment: (If receiving centrelink payments, you must provide statement attached to your
application).
Amount per fortnight:
Type of payment/s received:
References: Please provide references that are not related to you
Name:
Address:
Relationship:
Phone:
Name:
Address:
Relationship:
Phone:
Business/Work References:
Name:
Address:
Relationship:
Phone:
Name:
Address:
Relationship:
Phone:
Next of Kin/Emergency Contact:
Name:
Relationship:
Number:
Name:
Relationship:
Number:
Pets: If applying for a pet friendly rental, please provide photo of the animal
Do you own any pets: Y/N
Type:
Desexed: Y/N
Registered: Y/N
Type:
Desexed: Y/N
Registered: Y/N
Lawnmower: Y/N
Number of vehicles to be kept at property:
Car/s:
Motorcycle/s:
Other:
Please list all other persons who will occupy the property:
Name
Relationship
DOB
APPLICATIONS WILL NOT BE PROCESSED UNLESS ACCOMPANIED BY 100 POINTS
OF IDENTIFICATION AND A SIGNED PRIVACY ACT ACKNOWLEDGEMENT (PAGE 4)
One of the following Photo Identification MUST be presented:
Drivers Licence
Passport
Proof of Age Card
40 points
40 points
40 points
There must be one from the following supplied for income:
Current payslips (at least the past 3 current)
Centrelink Statements
Bank Statement (showing income into the account)
30 points
30 points
30 points
Please use the following to make up the remaining points:
Current Rent ledger/Rent receipts
Vehicle Registration papers
Current Utility bill
Current Rates notice
Medicare Card
Health Care Card
Birth Certificate
Written reference from landlord/agent
Bank Card
20
20
20
20
20
20
20
10
10
points
points
points
points
points
points
points
points
points
MINIMUM 100 POINTS REQUIRED
The purpose of providing these documents is to identify you as the applicant and verify the
information contained in your application.
Bond required (equal to 4 weeks rent)
Rent (first 2 weeks required)
$
$
Total
$
The total amount is to be paid in full by cash, Bank Cheque, or Money Order or
EFTPOS when signing the Residential Tenancy Agreement.
I will be in a position to commence the Residential Tenancy Agreement on
(date)…………………………………
and agree to pay a reservation fee equivalent to 1 weeks rent within 24 hours of
approval of my application. This amount will be applied to the rent at the commencement of
the tenancy. Should the application be withdrawn after the weeks holding deposit has been
received, the deposit will be forfeited.
I acknowledge and accept that if this application is rejected, the agent is not legally obliged
to give reasons for the rejection, unless the application has been rejected due to a listing on a
tenancy database.
By signing this application for tenancy the applicant authorises Siwicki Real Estate to retain
copies of the documents provided to achieve 100 points of identification/verification.
SIGNATURE.............................................................…………....Date......................................................