Application for Tenancy

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1 address Suite 514, 5 Celebration Drive Ta 21 Bella Vista NSW 2153 telephone fax website Application for Tenancy One application form per adult FULL NAME NAMES OF OTHER APPLICANTS APPLYING WITH YOU Along with your completed application, you must provide at least 100 points of identification including one form of photo identification. Items marked with an asterisk are compulsory items. Drivers License / Learners Permit / Proof of Age Card / Passport Birth Certificate Tenancy Ledger Bank Statement/s (Most recent - up to the last 3 months) Two Proof of Income Documents (Most recent) (Pay Slips / Wage Advice / Centrelink Statements) Utility bills with your current address (Phone / electricity / gas / etc.) Vehicle Certificate of Registration If self employed, please provide copies of business documents (Certificate of Business Registration / Profit/Loss Statements / Accountants Details) If you own a property, please provide proof of ownership (Council Rates / Water Rates / etc.) Medicare Card / Credit Card / Debit Card 30 POINTS* 20 POINTS 20 POINTS* 20 POINTS* 20 POINTS* 15 POINTS* 15 POINTS 15 POINTS* 15 POINTS 10 POINTS Important Information It is the responsibility of the applicant to ensure their own connection of all utilities such as telephone, electricity, gas and pay TV (where appropriate) on the date coinciding with the commencement of their tenancy. It is the responsibility of the applicant to hold insurance of their personal possessions. The landlord is not required to hold insurance which covers the personal possessions of the tenant. How did you hear about this rental property? (Please Tick / Answer) Other ULH material Word of Mouth (Family/friends, etc.) Local Newspaper Other (Please Specify) Page 1 of 6

2 address Suite 514, 5 Celebration Drive Ta 21 Bella Vista NSW 2153 telephone fax website Your FREE No Obligation Utility Connection Service Let us do the running around and call you to organize the connection of your utilities before you move in! STEP 1 Select the utilities you would like connected by ticking the relevant boxes below STEP 2 Fill out the relevant details on this form, sign it and lodge it with your property manager STEP 3 We will call you within 24 hours (except on weekends and public holidays) to confirm your details and connection timings Please tick utilities as required ELECTRICITY INTERNET GAS PHONE PAY TV INSURANCE Direct Connect Declaration And Execution: By signing this application, I/we: consent to Direct Connect arranging for the connection and disconnection of the nominated utility services and to providing information contained in this application to utility providers for this purpose; acknowledge having been provided with terms and Conditions of Supply of Direct Connect and having read and understood them together with the Privacy Collection Notice set out below; declare that all the information contained in this application is true and correct and given of their own free will; expressly authorise Direct Connect to provide any information disclosed in this Application to a supplier or potential supplier of the Services in accordance with the Privacy Collection Notice and to obtain any information necessary in relation to the Services; expressly authorize Direct Connect to provide any information disclosed in this Application to an information provider for the purpose of that information provider disclosing it to a supplier or potential supplier of the Services in accordance with the Privacy Collection Notice and to obtain any information necessary in relation to the Services; consent to Direct Connect contacting me by telephone or by SMS in relation to the marketing or promotion of all of the services listed under the heading Utility Connections above even if we/i have not applied for the connection of those services in this application. This consent will continue [for a period of 1 year from the date of our/my execution of this application/until [28] days after we/i disconnect the last of the services in respect of which this application is made]; acknowledge that this consent will permit Direct Connect to contact us/me even if the telephone numbers listed on this application form are listed on the Do Not Call Register; understand that under the requirements of the Privacy Act 1988, Direct Connect will ensure that all personal information obtained about me/us will be appropriately collected, used, disclosed and transferred and will be stored safely and protected against loss, unauthorized access, use, modification or disclosure and any other misuse; authorize the obtaining of a National Metering Identifier (NMI) for my residential address to obtain supply details; consent to Direct Connect disclosing my/our details to utility providers (including my/our NMI and telephone number); declare and undertake to be solely responsible for all amounts payable in relation to the connections and/or supply of the Services and hereby indemnify Direct Connect and its officers, servants and agents and hold them indemnified against any charges whatsoever in respect of the Services; acknowledge that, to the extent permitted by law, Direct Connect shall not be liable for any loss or damage (including consequential loss and loss of profits) to me/us or any other person or any property as a result of the provision of the services or any act or omission by the utility provider or for any loss caused by or in connection with any delay in connection, disconnection or provision of, or failure to connect or disconnect or provide, the nominated utilities; acknowledge that whilst Direct Connect is a free service I/we may be required to pay standard connection fees or deposits required by various utility providers; acknowledge that the Services will be provided according to the applicable regulations and that the time frames and terms and conditions of the nominated utility providers bind me/ us and that after hours connections may incur additional service fees from utility providers; acknowledge that the real estate agent listed on this application form may receive a benefit from Direct Connect in connection with the provision of the service being provided to me/us by Direct Connect; and acknowledge the entitlement of Direct Connect and its associates, agents and contractors, to receive a fee or remuneration from the utility provider and that such fee or remuneration will not be refunded to me as a rebate in connection with the provision of the utility connection services. By signing below, I warrant that I am authorised to make this Direct Connect application and to provide the consents, acknowledgements, authorisations and other undertakings set out in this application form on behalf of all applicants listed in this application form. APPLICANTS FULL NAME T F W Page 2 of 6

3 PROPERTY INFORMATION ADDRESS OF THE PREMISES APPLIED FOR WEEKLY RENT AMOUNT PREFERRED LEASE COMMENCEMENT POST CODE TENANCY TERM 6 MONTHS 12 MONTHS OTHER (SPECIFY) AMOUNT OF VEHICLES ARE YOU A SMOKER? YES NO OUTSIDE ONLY PLEASE PROVIDE THE DETAILS OF ALL OCCUPANTS ADULTS CHILDREN OCCUPANT 1 FULL NAME OCCUPANT 2 FULL NAME OCCUPANT 3 FULL NAME OCCUPANT 4 FULL NAME OCCUPANT 5 FULL NAME PETS YES NO DETAILS PERSONAL & CURRENT TENANCY/LIVING INFORMATION TITLE SURNAME GIVEN NAMES OF BIRTH CURRENT ADDRESS POST CODE DRIVER S LICENSE NO. PASSPORT NO. STATE COUNTRY EXPIRY EXPIRY PROOF OF CARD NO. STATE EXPIRY MEDICARE CARD NO. EXPIRY CAR REGISTRATION NO. STATE CAR MAKE CAR MODEL MANUFACTURE YEAR PENSION NO. TIME AT ADDRESS PENSION TYPE REASON FOR LEAVING LANDLORD/NT NAME LANDLORD/NT ADDRESS LANDLORD/NT PHONE LANDLORD/NT LANDLORD/NT MOBILE WEEKLY RENT PAID PREVIOUS TENANCY/LIVING INFORMATION PREVIOUS ADDRESS POST CODE TIME AT ADDRESS REASON FOR LEAVING LANDLORD/NT NAME LANDLORD/NT ADDRESS LANDLORD/NT PHONE LANDLORD/NT LANDLORD/NT MOBILE RENT PAID PER WEEK Page 3 of 6

4 CURRENT EMPLOYMENT INFORMATION EMPLOYMENT STATUS (TICK APPROPRIATE BOX) POSITION HELD PERMANENT FULL-TIME PART-TIME / CASUAL (SPECIFY AVER WEEKLY HOURS) SELF-EMPLOYED CENTRELINK RECIPIENT / PENSIONER SELF-FUNDED RETIREE STUDENT OTHER (SPECIFY) WORKING PERIOD EMPLOYER NAME EMPLOYER ADDRESS EMPLOYER TELEPHONE EMPLOYER EMPLOYER MOBILE PAYROLL/CONTACT NAME INCOME (AFTER TAX) PER WEEK FORTNIGHT OTHER PREVIOUS EMPLOYMENT INFORMATION POSITION HELD WORKING PERIOD EMPLOYER NAME EMPLOYER ADDRESS EMPLOYER TELEPHONE EMPLOYER EMPLOYER MOBILE PAYROLL/CONTACT NAME INCOME (AFTER TAX) PER WEEK FORTNIGHT OTHER REFEREE 1 NAME PERSONAL REFERENCES OCCUPATION RELATIONSHIP TO YOU REFEREE 2 NAME OCCUPATION RELATIONSHIP TO YOU EMERGENCY CONTACT INFORMATION In case of an emergency, please provide the contact details of your nearest friend / relative / next of kin NAME RELATIONSHIP TO YOU ADDRESS ACKNOWLEDGEMENT The applicant acknowledges and consents to the Agent verifying my identity through conducting reference checks. These reference checks could involve the direct contact with any referees mentioned by the applicant listed on this application form and/or otherwise advised by the applicant. I understand that by not conducting these checks, the Agent may be unable to process my application. Page 4 of 6

5 APPLICATION TYPE OF PREMISES FURNISHED UNFURNISHED INITIAL PAYMENTS RENTAL BOND AMOUNT ADVANCE RENT AMOUNT SUB TOTAL LESS RESERVATION FEE EQUIVALENT TO DAYS INITIAL RENT AND BOND PAYMENT MUST BE IN BANK / CREDIT UNION CHEQUE, MONEY ORDER OR VIA DIRECT DEPOSIT. PERSONAL CHEQUES OR CASH WILL NOT BE ACCEPTED The Landlord s Agent undertakes: (a) the premises will not be let during the Reservation Period, pending the agreement of a residential tenancy agreement; (b) the whole fee will be refunded if the landlord does not decide to enter into a residential tenancy agreement for the premises during the Reservation Period; (c) the whole fee will be refunded if the landlord does not carry out (during the Reservation Period) repairs or other work upon which is a condition to entry into a residential tenancy agreement; (d) if the Applicant decides not to enter into a residential tenancy agreement, and the premises are not let or otherwise occupied during the Reservation Period, the landlord may retain the portion of the fee representing the rent that would have been paid during the Reservation Period (based upon the proposed rent), but must refund the remainder; and (e) if a residential tenancy agreement is entered into, the fee is to be contributed towards rent for the premises. DETAILS OF ANY REPAIRS OR OTHER WORK TO BE CARRIED OUT BY THE LANDLORD: DECLARATION I hereby offer to rent the property from the owner under a lease to be prepared by the agent. I acknowledge that I will be required to pay the amounts specified above and also accept to sign up to direct debit upon signing lease agreement. I acknowledge that this application is subject to the approval of the owner/landlord. I declare that all the information contained in this application is true and correct and given on my own free will. I will declare that I have inspected the property and that I am not Bankrupt. I authorise the Agent to obtain personal information from: (a) the owner or the Agent of my current or previous residence; (b) my personal referees and employer/s; (c) any record, listing or database of defaults by tenants. If I default under a rental agreement, the Agent may disclose details of any such default to a tenancy default database, and to agents/ landlords of properties I may apply for in the future. I am aware that the Agent will use and disclose my personal information in order to: (a) communicate with the owner and select a tenant; (b) prepare lease/tenancy documents; (c) allow organizations/tradespeople to contact me; (d) lodge/claim/transfer to/from the Residential Tenancies Bond Authority; (e) refer to Tribunals/Courts & Statutory Authorities (where applicable); (f) refer to collection agents/lawyers (where applicable) I am aware that if information is not provided or I do not consent to the uses to which personal information is put, the Agent cannot provide me with the lease/tenancy of the premises. I am aware that I may access personal information on the contact details above. NOTICE: Section 42A If you dispute all or part of the amount specified in this statement and if you have been unable to resolve the dispute, you may apply to the NSW Office of Fair Trading and/or the NSW Consumer, Trader and Tenancy Tribunal (CTTT) for a determination of the matter. Legal action to recover the amount specified in this statement cannot be commenced until 28 days after it has been served on you. TRADING REFERENCE AUSTRALIA PTY LTD PO BOX 372, ROSE BAY NSW 2029 T: F: E: W: NATIONAL TENANCY DATABASE PTY LTD GPO BOX 13294, GEORGE STREET, BRISBANE QLD 4003 T: F: E: W: TICA DEFAULT TENANCY CONTROL PTY LTD PO BOX 120, CONCORD NSW 2137 T: W: APPLICANTS FULL NAME OFFICE USE ONLY REFERENCES CHECKED BY TRA/TICA/NTD CHECK OK COMMENTS CURRENT LANDLORD/NT OK COMMENTS PREVIOUS LANDLORD/NT OK COMMENTS EMPLOYMENT OK COMMENTS EMPLOYMENT REFEREE NOTES APPLICATION SUBMITTED OK COMMENTS APPLICATION RESULT APPROVED DECLINED WITHDRAWN DIRECT CONNECT SENT OK COMMENTS Page 5 of 6

6 address Suite 514, 5 Celebration Drive Ta 21 Bella Vista NSW 2153 telephone fax website ADDITIONAL TENANCY INFORMATION Applications will only be processed upon receipt of a completed and signed tenancy application All adults who intend to reside at the premises must complete and submit a tenancy application form Bond transfers are not accepted A reservation fee will not be accepted until an application is approved by the property landlord Once an application has been approved, a reservation fee equivalent to one weeks rent must be paid within 48 hours of approval being given. If the reservation fee is not received by the Agent within this time, the property will remain on the market and the Agent will continue to accept other applications for tenancy from other prospective tenants The Agent reserves the right to allow for any changes or additions to this application form without notice. Should an application fail to contain the requested information, the Agent may not be able to process the application. APPLICATION FOR TENANCY - PRIVACY DISCLOSURE STATEMENT PRIVACY ACT 1988 The personal information the prospective tenant provided in this application or collected from other sources is necessary for the agent to verify the applicant s identity, to process and evaluate the application and to manage the tenancy. Personal information collected about the applicant in this application and during the course of the tenancy if the application is successful may be disclosed for the purpose for which it was collected to other parties including landlords and their advisers, referees, other agents and third party operators of tenancy reference databases. Information already held on tenancy reference databases may also be disclosed to the agent and or landlord. If the applicant enters into a residential tenancy agreement and If the applicant fails to comply with their obligations under that agreement, that fact and other relevant personal information collected about the applicant during the course of the tenancy may also be disclosed to the landlord, third party operators of tenancy reference databases and or other agents. If the information provided is not true or complete then this agency may not be able to process the application for tenancy. If the applicant would like access to the personal information the agent holds they can do so by contacting the manager at: URBAN LAND & HOUSING GROUP PTY LTD SUITE 514, LEVEL 5 5 CELEBRATION DRIVE BELLA VISTA NSW 2153 TELEPHONE: : Any information collected and not used or no longer required for our records will be shredded. I, the said applicant, declare that I give my permission to the agent to collect my information and pass such information onto the landlord, operators of tenancy reference databases or other agents. APPLICANT S FULL NAME APPLICANT S REAL ESTATE NT S Page 6 of 6

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