Part 1: Rental Property Details

AGENCY NAME:

ADDRESS:

ADDRESS:

TenancyTerm: Fixed term agreement

Part 2: Applicant Details

Have you been known by any other name(s)?YesNo

If Yes, what other name(s) have you been known by?

Do you have any dependants?YesNo

Are you or any of the dependants living with you a smoker?YesNo

If Yes, please state which council:

CURRENT RESIDENTIAL ADDRESS:

CURRENT AGENT/LESSOR (If renting):

PREVIOUS RESIDENTIAL ADDRESS:

PREVIOUS AGENT/LESSOR:

Are you employed?YesNo (if no, please provide details of previous employer, if any)

Employment status?Full timePart timeCasualContractSelf employed

EMPLOYER/BUSINESS NAME:

ADDRESS:

Are you receiving any regular Centrelink payments?YesNo

DESCRIPTION OF PAYMENT(S):

Are you studying full time?YesNo

Please do not list relatives, another applicant or partners and provide business hours contact numbers.

ADDRESS:

ADDRESS:

i.e. preferred person(s) to be contacted in the event of an emergency.

ADDRESS:

ADDRESS:

Part 3: Supporting Documents

You are required to meet a 100 point identification criterion upon submission of your application. The Agent/Lessor may photocopy any item and retain as part of your application.

Please tick the identifying documents you have provided with your application.

IMPORTANT: At least one form of Photo Identification MUST be provided.

70 Points

PassportFull birth certificateCitizenship certificate

40 Points

Australian Driver's LicenceStudent Photo IDDepartment of Veterans Affair cardCenterlink cardProof of age cardState/Federal Government Photo ID

25 Points

Medicare cardCouncil rates noticeMotor Vehicle registrationTelephone billElectricity billGas billTenancy History LedgerBank statementCredit card statementLast FOUR rent receiptsRent bond receiptPrevious tenacy agreement

You are also required to supply the Agent/Lessor with proof of your income upon submission of your application.

Part 4: Declaration

Please declare the following by selecting either TRUE or FALSE

I, the Applicant

1. 1. Have never been evicted by an Agent/LessorTrueFalse
2. 2. Have no known reasons that would affect my ability to pay rentTrueFalse
3. 3. Was refunded the rental bond for my last address in full (if applicable)TrueFalse
   If false, please advise what deductions were made from your bond?
   
4. 4. Have no outstanding debt to another Agent/Lessor?TrueFalse
   If false, why are you in debt to your past Agent/Lessor?
   

Part 5: Tenancy Database

The Agency may use the following tenancy database to check the rental history of the Application/s:

Part 6: Acknowledgement

Please acknowledge the following by selection either YES or NO

I, the Applicant

1. Acknowledge that my personal contents insurance is not covered under any Lessor insurance policy/s and understand that it is my responsibility to insure my own personal belongings.YesNo
2. Understand that you as the Agent/Lessor have collected this information for the purpose of determining whether I am a suitable tenant for the property - in particular to check my identification, my ability to care for the property, my character and my creditworthiness.YesNo
• for such purposed, I authorise you to contact the persons named in this application, and to undertake such enquires and searches (including tenancy database searches) as you consider reasonably necessary.YesNo
• in doing so, I understand that information provided by me may be disclosed to, and further information obtained from, referees named in this apllication and other relevant third parties.YesNo
3. Acknowledge and accept that if this application is denied, the Agent is not legally obliged to provide reasons as to why.YesNo
4. Consent and understand that should my tenancy be accepted and upon commencement of the tenancy agreement, there may be cause for the Agent/Lessor to pass my details onto others which may include (but is not limited to) insurance companies, body corporates, contractors, other real estate agents, salespeople and tenancy default database.YesNo
5. Acknowledge that I have received and reviewed the General Tenancy Agreement (Form 18a), the Standard Terms and any special terms before completing this application.YesNo
6. Acknowledge that I have received or have availabel the Information Statement (Form 17a), body corporate by-laws (if applicable) before completing this application.YesNo
7. Acknoeledge that I have signed the agency's Privacy Notice and Consent.YesNo
8. Acknowledge that the Lessor and Applicant (tenant) are bound by this agreement immediately upon communication of either the lessor or agent's acceptance of the application.YesNo
9. Consent to the use of email and facsimile in accordance with the provisions set out in Chapter 2 of the Electronic Transactions (Queenland) Act 2001 (Qld) and the Electronic Transactions Act 1999 (Cth).YesNo
10. Declare that the above information is true & correct and that I have supplied it for my own free will.YesNo