Residential Tenancy Application Form

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Please complete all sections of the application form. You will also need to provide a personal credit report, not more than three months old, and 100 points of ID. CREDIT REPORT A credit report may be obtained from Tasmanian Collection Service, 29 Argyle Street, Hobart ( Telephone (03) 6213 5555 ). If you have not been resident in Tasmania within the last six months, you will need to provide a national report, obtainable from Veda or Baycorp Advantage. EACH RESIDENT MUST FILL OUT THIS FORM Please note that a separate form, together with supporting documentation, is required for each person over the age of 18 who intends to reside in the property. REFERENCES REQUIRED A minimum of three references is required, and no application can be processed until you have supplied all the required documentation. TURNAROUND TIME We aim to assess all applications within 48 hours. However, if we are unable to contact your referees or the property owner, the process may be unavoidably delayed. 100 Points of ID May be made up of any of the following: Passport 50 Points Driver s Licence 40 Points Photo ID (such as Student card) 30 Points Birth Certificate 30 Points Medicare Card 30 Points Health Care Card 30 Points ADDRESS OF PROPERTY YOU ARE APPLYING FOR: Preferred Lease Term:................... Preferred Lease Start Date:.................. YOUR CONTACT DETAILS Your name:......................................................... Date of Birth:............ Phone No:............ Mobile:.................. Current address:..................................................... Email address:....................................................... (03) 6261 4222 www.derwentrealestate.com.au Email: zac@derwentrealestate.com.au Fax: (03) 6261 5744 73 High Street, New Norfolk, Tasmania 7140 abn 17 091 770 428

Page 2 of 5 EMPLOYMENT INFORMATION Current Employer:.................................................... Employer Address:.................................................... Position:................................... Weekly Income $:............ How long have you worked for this employer? :................................... Previous Employer:.................................................... Employer Address:.................................................... Position:................................... Weekly Income $:............ How long did you work for this employer? :...................................... IF YOU ARE A PENSIONER, STUDENT OR UNEMPLOYED Please state the amount of income you receive per fortnight $:........................ From:..................................... (e.g Centrelink or Pension Fund) Type of Pension:.............................. (e.g Parenting or Disability) If you are receiving a regular payment from Centrelink, please attach your income statement to this application. CURRENT LIVING ARRANGEMENTS I am renting I own my own property Other (Please tick one) Length of time at this address:............................................ If you are renting, please provide details of your landlord or managing agent. Name of Owner or Managing Agent:......................................... Do you have a current lease at this property? If so when does your lease expire?..............

Page 3 of 5 PREVIOUS TENANCY INFORMATION (If applicable) Previous address:..................................................... Length of time at this address :............................................ Name of Owner or Managing Agent:......................................... Phone No:.............. Email:............... Fax: PERSONAL DETAILS How many children will be living with you at the property, full time?....................... How many children will be living with you at the property, part time?...................... Do you have any pets? Yes No If yes please provide details.............................................................................................................................................................................. If you have a dog (or dogs) are they registered with the council Yes No Do you smoke No Yes, outside only Yes, inside and outside BUSINESS OR RENTAL REFEREES

Page 4 of 5 PERSONAL REFEREES (Please note, family members may not supply a reference). NEXT OF KIN Address:................................... Phone:................... Relationship to you:............................. (e.g Mother, Father) APPLICATION SUBMISSION I acknowledge that all information contained in this application is true and correct and that all of the information was given of my own free will. I further authorise the letting agent to contact and/or conduct any enquiries and or searches in relation to the information and references supplied in this application. I confirm I have inspected the property prior to signing this application. Signature of Applicant........................... Date....................

Page 5 of 5 Privacy Act (Commonwealth 1998) Collection Notice The personal information the prospective tenant provides in this application or that which is collected from other sources is necessary for the Agent to verify the Applicant s identity, to process and evaluate the application and effectively manage the tenancy. The personal information collected about the Applicant may be disclosed, by use of the internet or otherwise, to other parties, including the landlord, tradespeople, referees, solicitors, financial institutions, media organisations, parties engaged to evaluate the property, bodies corporate, other agents, clients of the Agent both existing and potential, third party operators of tenancy reference databases, government, collection agencies, relevant Courts and Tribunals, and statutory bodies and other third parties as required by law. Information already held on tenancy reference databases may also be disclosed to the Agent and/or landlord. Unless you advise the Agent to the contrary, the Agent may also disclose such basic information to The Real Estate Institute of Tasmania Ltd (REIT), for the purpose of documenting leasing data in the area for the benefit of its members as part of membership services and for others in the property or related industries, and so as to assist them in continuing to provide the best possible service to their clients. In providing this information, you agree to its use, unless you advise the Agent differently. The privacy policy of the REIT can be viewed on its website www.reit.com.au The Agent will only disclose information in this way to other parties to achieve the purposes specified above or as otherwise allowed under the Privacy Act. If the Applicant would like to access this information they can do so by contacting the Agent at the address and contact numbers contained in this Application, or the REIT on (03) 6223 4769. The Applicant can also correct this information if it is inaccurate, incomplete or out of date. I acknowledge that I have read and understood the contents of the Privacy Collection Notice. Signature of Applicant........................... Date.................... Email: zac@derwentrealestate.com.au Fax: (03) 6261 5744 73 High Street, New Norfolk, Tasmania 7140