Rex Davy Real Estate MREINZ (Licensed REAA 2008): Application for Residential Tenancy

Application for Residential Tenancy

Property Applied Address: Date Required:

Applicant Details To:
Title:
First Name:
Middle Name:
Surname:
Contact Phone Number (Day):
Mobile:
No. of Children:
Ages:
Details of Pets:
Smoking:YesNo

Drivers' Licence / Passport / Other ID
Car Registration No:
Date of Birth:
Email Address:

Spouse Title:
Full Name:
Date of Birth:
Drivers' Licence / Passport / Other ID

Next of Kin Name:
Relationship:
Address
Home Phone:
Business Phone:

Occupation Occupation:
Name of Employer:
Address
Student:Yes No

Institution:
Course:
Period of Employment:
Business Phone:

Occupation of Spouse Occupation:
Name of Employer:
Address
Student:Yes No

Institution:
Course:
Period of Employment:
Business Phone:

Present Address Present Address:
Period of Occupancy:
Rent Paid:
Name of Agent of Owner
Business Phone:
Reason for Leaving:

Previous Address Present Address:
Period of Occupancy:
Rent Paid:
Name of Agent of Owner
Business Phone:
Reason for Leaving:

Other Intended Occupants (They need their own application form) Full Name:
Relationship:
Full Name:
Relationship:

Personal Information to support this application

Personal References: (No relatives. Names given must be contactable during business hours)

1. Name:
Phone:
2. Name:
Phone:
Name of person to contact in case of emergency:
Phone:
Mobile:

Confirm Application

PRIVACY ACT 1993 - Authority to Use Information

I/We authorise any person or company to provide you with such information as you may require in response to your credit and/or employment inquires.
I/We further authorise you to furnish any third party details of this application and any subsequent dealings that I/We may have with you as a result of this application being actioned by you.

I UNDERSTAND AND AGREE THAT ALL RENTAL PAYMENTS WILL BE PAID BY AUTOMATIC PAYMENT

PRIVACY ACT 1993 STATEMENT

For the purposes of this Privacy Act 1993;

This application collects personal information about you
This information is required to;
- Assess your eligibility as a tenant
- Collect information that 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)
The information in this Tenant application form will, if you enter into a Tenancy Agreement with us, be held on a database and used by us and by the owner of the rented property.
Failure to provide any of the information requested may mean you will not be considered as a tenant for any of the properties within the Privacy Act.
You are entitled to access and correct this information that is held about you.