Tenancy Application Form

Date: * of ,
Street address applying for: *
Rent per week: *
Move in date: * of ,
Surname of applicant: *
First names: *
Contact numbers:
Home:
Mobile: *
Work:
Email (if you don't have an email, please put 'N/A'): *
Date of birth: * of ,
Bank: *
IRD number: *
Drivers license number (5a) or passport number: *
COMPULSORY: For drivers licence - include 5B number:
Vehicle make & model:
Registration number:
Smokers?: * Yes No
Children: * Yes No
If yes, what ages?
Pets: * Yes No
Number of people to reside: *
Current address: *
Period of time at current address:
Did you: *
Landlord or agents name:
Contact number:
Reason for leaving:
Current rent:
Previous address:
Period of time at previous address:
Did you:
Landlord or agents name:
Current employer: *
Employers address:
Position:
How long with this employer: *
Phone number: *
Work referee: *
Source of income: *
If you selected 'Beneficiary' please enter your client number.:
Gross weekly income: *
Previous employer (if less than 2 years at current employment):
Employers address:
Position:
How long with this employer:
Phone number:
Work referee:
Next of kin or contact relative: *
Contact number: *
Address: *
Relationship: *
This application form collects personal information about you. All unsuccessful application forms will be destroyed. Successful application forms will be retained by ASCENT PROPERTY MANAGEMENT LTD and/or the landlord. You have the right to see and, if necessary, correct information held. If you enter into a Tenancy Agreement and fail to comply with the terms of that agreement information will be sent to a Credit Bureau or Tenant Default database. I/We authorise ASCENT PROPERTY MANAGEMENT LTD to make independent checks of the information provided in this application including checks with the people I have named as referees and any other Credit Bureau or Tenant Default Databases.
Full name: