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> Individual Tenancy Application A separate application is required for each adult resident to avoid delays give full details this form MUST be completed prior to carrying out credit searches Prospective Tenant Details: Title: Mr/Mrs/Miss/Ms/Dr/Revd: First Last Middle Name/s: Any Previous Names in Full: Time Spent at this address: Years: Months: Telephone No s (Include STD) Your e-mail address: Home: Work: Mobile: Identification (Please supply NI number with driver s licence or passport, plus photocopy showing your photo) Date of Birth: National Insurance Driver s Licence Passport Status: (tick box) Single Married Divorced Widowed Living with Partner House owner: (tick box) Council Tenant Private Tenant Lodger Living with relatives/friends Answer clearly write YES or NO Smoker? Pets? County Court Judgements? Court Decree? Bankruptcy? Evictions? Criminal Convictions? Administration Orders? If you have answered yes to any of these questions, please provide details below (continue onto back of sheet if necessary) Previous Addresses - Full addresses for last three years including postcodes, dates and reasons for moving continue on next page if necessary. Tenancy Application Form 1

Present Landlord or, Letting Agent Solicitor Estate Agent (tick appropriate box) Full Previous Landlord or, Letting Agent Solicitor Estate Agent (tick appropriate box) Full Present Occupation (tick appropriate box) Employed Self Employed On-contract Retired Un-employed Student Independent Means Employer: Line Manager or other contact: Date started this employ: Fax: Employer Tel: Email: Tenancy Application Form 2

Employee Ref No: Gross Annual Earnings Position Held: Your work Fax: Your work Is your employment Permanent? Your work email: Do you plan to change employment soon? Previous Occupation (if in above less than 3 years) Employer: Line Manager or other contact: Post code: Date Started this employ: Proposed additional residents - Names, full addresses and occupations: Bank or Building Society Details: Bank or Society Current A/c Bank Branch Bank Account Sort Code: Vehicle(s) to be kept at the property (include cycles, motor cycles and caravans) Make & Model: Registration Numbers: Tenancy Application Form 3

Surety Guarantor / Referee (where applicable) Full Occupation: Telephone (inc STD) Next of Kin / Emergency Contact (Not spouse or live-in Partner) Full Occupation: Telephone (inc STD) I apply for a Tenancy at: (full description and address of property) For a period of: The rental amount is per: payable by Cheque/Standing Order. I will be directly responsible for Council Tax, and for opening accounts with service providers and paying directly to them for all services to the property. I will pay one month s rent in advance plus a security deposit of I believe the information provided here to be true and authorise the landlord or agent to: Carry out credit searches and reference checks and to contact employers, banks, referees, guarantors and credit reference agencies. Use the information obtained with third parties to assess credit ratings, make insurance decisions, for fraud prevention and tracing / debt collection. Handle all information obtained in strictest confidence and in accordance with the principles of the Data Protection Act 1988. I understand that the 250 holding deposit is non-refundable non-transferable should I decide not to proceed. I understand that I can request the details of any credit reference agencies used so that I can verify with them the information provided. I understand that if I default on my tenancy obligations, this information may be released to authorised debt recovery agencies and could affect any future applications I make for tenancies, credit and insurance. Completing this form does not commit the prospective tenant or landlord to a tenancy. A shared or single tenancy will not be created until all applicants have been qualified and have signed the tenancy agreement. I can confirm that I have read the above and have raised any concerns with the landlord or agent. Prospective tenants should be aware that any false statement made could result in early termination of the tenancy under ground 17 of the Housing Act 1996. Tenancy Application Form 4

Signature of Applicant Date: / / Print full name below in BLOCK CAPITALS: Please return this form with supporting documentation to: Walton & Allen Limited Ground Floor, Price House, 37 Stoney Street, The Lace Market, Nottingham. NG1 1LS Tel : 0115 924 3304 Fax : 0115 985 9391 info@waltonandallen.co.uk Tenancy Application Form 5