Accredited Agency Application for Residential Tenancy (One application to be completed per person) PART 1: RENTAL PROPERTY DETAILS ITEM 1: AGENT DETAILS AGENCY NAME: ZEB realty PO BOX 1852 BUDERIM QLD 4556 PHONE: MOBILE: FAX: EMAIL: 0433 466 994 rentals@zebrealty.com.au ITEM 2: PROPERTY DETAILS Rent: Rent period: weekly / fortnightly / monthly Bond: à Tenancy Term: Fixed term agreement Periodic agreement Starting on: Ending on: ITEM 3: PART 2: APPLICANT DETAILS CONTACT DETAILS FULL NAME: DATE OF BIRTH: Have you been known by any other name(s)? If, what other name(s) have you been known by? WORK PHONE: MOBILE: HOME PHONE: EMAIL: Driver s Licence/passport number: Number of vehicles: State: Registration number(s): ITEM 4: DEPENDANTS Do you have any dependants? DEPENDANT FULL NAME(S): RELATIONSHIP TO APPLICANT: DEPENDANT DATE OF BIRTH: ITEM 5: SMOKING Are you or any of the dependants living with you a smoker? ITEM 6: PETS Do you intend to keep pets at the property? Number of pets: Type of Pet/s: Are your pets registered with a council? If, please state which council: EF015 v03/14 Copyright The Real Estate Institute of Queensland Ltd Page 1 of 4
ITEM 7: APPLICANTS ADDRESS HISTORY CURRENT RESIDENTIAL PERIOD OF OCCUPANCY: SUBURB: CURRENT AGENT/LESSOR (If renting): STATE: TYPE OF OCCUPANCY: Rent Owner Other: à AGENT/LESSOR PHONE: POSTCODE: CURRENT RENT Rent period: à weekly / fortnightly / monthly REASON FOR LEAVING: PREVIOUS RESIDENTIAL PERIOD OF OCCUPANCY: PREVIOUS AGENT/LESSOR: SUBURB: STATE: TYPE OF OCCUPANCY: Rent Owner Other: à AGENT/LESSOR PHONE: POSTCODE: PREVIOUS RENT: Rent period: à weekly / fortnightly / monthly REASON FOR LEAVING: ITEM 8: EMPLOYMENT DETAILS Are you employed? (if no, please provide details of previous employer, if any) Employment status: Full time Part time Casual Contract Self employed OCCUPATION: DATE COMMENCED EMPLOYMENT (approx.) NET INCOME (per week) DATE TERMINATED EMPLOYMENT (if any): EMPLOYER/BUSINESS NAME: PHONE: IF SELF EMPLOYED, ACCOUNTANT S NAME: PHONE: ITEM 9: CENTRELINK PAYMENTS Are you receiving any regular Centrelink payments? DESCRIPTION OF PAYMENT(S): TOTAL INCOME (PER WEEK): DATE PAYMENTS COMMENCED: ITEM 10: STUDENT DETAILS Are you studying full time? NAME OF EDUCATION INSTITUTION YOU ARE CURRENTLY ATTENDING: STUDENT IDENTIFICATION NUMBER: Are you an overseas student? If yes, Visa expiry date: EF015 v03/14 Copyright The Real Estate Institute of Queensland Ltd Page 2 of 4
ITEM 11: PERSONAL REFERENCES Please do not list relatives, another applicant or partners and provide business hours contact numbers. REFEREE 1: REFEREE 2: ITEM 12: PERSONAL REPRESENTATIVE i.e. preferred person(s) to be contacted in the event of an emergency. REPRESENTATIVE 1: REPRESENTATIVE 2: PART 3: SUPPORTING DOCUMENTS ITEM 13: IDENTIFICATION 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 Passport Full birth certificate Citizenship certificate 40 Points Australian Driver s Licence Student Photo ID Department of Veterans Affairs card Centrelink card Proof of age card State/Federal Government Photo ID 25 Points Medicare card Council rates notice Motor vehicle registration Telephone bill Electricity bill Gas bill Tenancy History Ledger Bank statement Credit card statement Last FOUR rent receipts Rent bond receipt Previous tenancy agreement ITEM 14: PROOF OF INCOME You are also required to supply the Agent/Lessor with proof of your income upon submission of your application. Employed: Self employed: t employed: Last TWO pay slips. Bank statements, Group Certificate, Tax Return or Accountant s letter. Centrelink statement. EF015 v03/14 Copyright The Real Estate Institute of Queensland Ltd Page 3 of 4
PART 4: DECLARATION PLEASE DECLARE THE FOLLOWING BY SELECTING EITHER TRUE or FALSE I, the Applicant 1. Have never been evicted by an Agent/Lessor True False 2. Have no known reasons that would affect my ability to pay rent True False 3. Was refunded the rental bond for my last address in full (if applicable) True False If false, please advise what deductions were made from your bond? 4. Have no outstanding debt to another Agent/Lessor? True False If false, why are you in debt to your past Agent/Lessor? PART 5: ACKNOWLEDGEMENT PLEASE ACKNOWLEDGE THE FOLLOWING BY SELECTING 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. 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. 2.1 for such purposes, I authorise you to contact the persons named in this application, and to undertake such enquiries and searches (including tenancy databases searches) as you consider reasonably necessary. 2.2 in doing so, I understand that information provided by me may be disclosed to, and further information obtained from, referees named in this application and other relevant third parties. 3. Acknowledge and accept that if this application is denied, the Agent is not legally obliged to provide reasons as to why. 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 databases. 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. 6. Acknowledge that I have received or have available the Information Statement (Form 17a), body corporate by-laws (if applicable) before completing this application. 7. Acknowledge that I have signed the agency's Privacy tice and Consent. 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. 9. Consent to the use of email and facsimile in accordance with the provisions set out in Chapter 2 of the Electronic Transactions (Queensland) Act 2001 (Qld) and the Electronic Transactions Act 1999 (Cth). 10. Declare that the above information is true & correct and that I have supplied it of my own free will. Name of Applicant: Signature: Date: EF015 v03/14 Copyright The Real Estate Institute of Queensland Ltd Page 4 of 4
For rental applications in NSW, QLD (South), SA Tariffs and charges We will email you a link with the prices and charges for your selected product upon receipt of your request for that product and also provide you with an opportunity to opt-out at this time. Contract term The contract commences when you satisfy any pre-conditions that may be specified in it. The contract may be terminated by you giving notice of termination or by agreement between you and the retailer. The contract will also end if energy is bought for the premises under a different contract or, in some cases, if the premises are disconnected. In addition, the retailer might be entitled to terminate the contract where you are in breach of it or if you vacate the relevant premises. Billing and payment arrangements Bills will be issued at least once every 3 months. You may generally pay your bills in person, by telephone, by mail, by direct debit or by electronic funds transfer. In certain circumstances, you may also be able to pay your bills by using Centrepay. Concessions or rebates If you hold a current government concession card you may be entitled to receive a rebate on your bill. Further information about the concessions and rebates that may be available to you can be obtained from the retailer. Service levels The service will comply with all laws and regulatory requirements applicable in the state or territory in which the supply address is located. Cooling off period If a cooling off period applies to your contract (which will typically be the case only where it is a market retail contract), then you may cancel the contract within 10 business days of receiving the retailer s welcome pack by informing the retailer by telephone or in writing of your intention to cancel the contract. Electronic transactions If any requirement in connection with the service is to be met electronically, it will be met in accordance with the contract. You will be recognised as having received the information and be bound by the transaction in accordance with applicable laws, regulatory requirements and the contract. Complaints You may complain to the retailer about the Service Provider. Contact the retailer if you wish to do this. If your complaint is not satisfactorily resolved by the retailer, then you may complain to the energy ombudsman. ebilling and Welcome Pack Unless you request otherwise, your electricity and/or gas bills will be sent to the email address provided in your rental application form., please post these items to me in hard copy to my new address (please tick) Explicit Informed Consent By signing below, I/we understand and agree: that I/we have read and accept the prices and charges applicable to the selected energy product; that, subject to the terms of the selected contract and any applicable legislation, the selected retailer may vary the energy rates which are used to calculate the applicable usage charges from time to time, and can vary the tariff structure, charges, billing frequency, and the terms of the contract at any time by writing to me/us; to become a customer of the selected retailer in accordance with the terms and conditions of the selected contract, including by transferring to that retailer, if the retailer agrees to provide me/us with my/our chosen product on those terms and conditions. Tenant Signed Co-Tenant (if any) Signed Date X X DD/MM/YYYY Please note, if you select ANY of the products displayed above, you must acknowledge your consent to the above information, our Privacy Collection Statement and you being contacted by our Service Provider in relation to the selected products, by providing your signature. Privacy Collection Statement realestate.com.au collects and uses the information in this form and your tenant application form to provide the connection service and will disclose this information to its Service Provider and to your chosen energy and telecommunication retailer(s). realestate.com.au may also use the information to promote its other services, and services of trusted third parties. realestate.com.au s Privacy Policy at www.realestate.com.au/privacy further explains how realestate.com.au collects, uses and discloses personal information and how to access, correct or complain about the handling of personal information. You agree that the personal information you provide to us (or authorise to be provided to us) is your information, or information which you have been authorised to provide us. Where you are authorised to provide another individual s information to us, you must inform that individual that their personal information will be used and disclosed by us in accordance with our Privacy Policy www.realestate.com.au/privacy and these terms and conditions. www.realestate.com.au/connect 1300 489 106