| Property Details |
| Address of the property you wish to apply for |
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| Lease commencement date |
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| Lease term |
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Number of people occupying the property
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Adults Children |
| If successful is there a specific day you would like to pay the rent? |
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| If there is please specify here |
on a |
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or a specific day of the month (please choose day) |
| Do you have any pets? |
Are they desexed? |
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If yes please state type |
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| Personal Details |
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| Given name(s) |
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| Surname |
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| Date of birth |
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| Current address |
Street |
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Suburb |
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City |
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| Previous address |
Street |
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Suburb |
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City |
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| Phone numbers |
Home |
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Work |
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Mobile |
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Fax |
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| E-mail address |
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| Drivers licence number |
5a |
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5b |
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| Passport number |
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| Super Gold card number |
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| Names of other applicants that go with this application |
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| Next of Kin (Must be a New Zealand Contact, not living at the same property. This will be used as your address for service) |
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| Given name(s) |
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| Surname |
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| Relationship to you |
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| Address |
Street |
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Suburb |
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City |
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| Phone number |
Home |
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Mobile |
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| E-mail address |
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| Current Tenancy Details or Ownership History |
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| Lenght of time at current address |
Years Months |
| Rent paid per week |
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| Reason for leaving |
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| Name of landlord/ selling agent |
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| Phone number |
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| Previous Rental History or Ownership History |
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| Previous address |
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| Lenght of time at above address |
Years Months |
| Rent paid per week |
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| Name of landlord/ selling agent |
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| Phone number |
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| Current Employment |
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| Occupation (If you are a beneficiary please state) |
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| Current empolyer |
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| Employers address |
Street |
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City |
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| Contact name (Pay roll / Manager / WINZ Case Worker) |
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| Contact number |
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| Length of employment |
Years Months |
| Net Income |
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| Self Employment Details |
| Company Name |
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| Business Type |
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| Business Address |
Street |
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City |
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| Position Held |
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| Accountant Name |
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Phone Number
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| Net Income (per annum) |
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| Previous Employment |
| Occupation |
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| Employers Address |
Street |
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City |
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| Contact Name (pay roll/manager) |
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Contact Number
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| Length of Employment |
Years Months |
| Net Income (per annum) |
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| Study Details |
| Place of Study |
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| Course Name |
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| Course Length |
Years Months |
| Enrolment/Student Number |
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| Referees |
| Referee Name |
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| Relationship to you |
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| Home/business phone number |
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| Mobile phone number |
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| Referee Name |
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| Relationship to you |
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| Home/business phone number |
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| Mobile phone number |
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| Please also answer the following |
| Have any of your previous tenancies been terminated? |
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Are you in debt to another lessor or agent?
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| Is there an existing reason that may affect your rent payments? |
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| If yes, please provide details |
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| Privacy Statement |
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We are an independantly owed and operated business. We are bound by the Privacy Act 1993. We collect personal information about you in this form to assess your application for a residential tenancy. We may need to collect information about you from your previous landlords or letting agents, your current employer, credit agencies and your referees. Your consent to us collecting this information is set out below. We may disclose personal information about you to the owner of the property to which this application relates. If this application is successful we may disclose your contact details to maintenance contractors and the landlord's insurers. We may also send personal information about you to the owners of any other properties at your request. You have the right to access personal information that we hold about you by contacting our office. If you do not complete this form or agree to the privacy consent then your application for a residential tenancy may not be considered by the owner of the relevant property or, if considered, may be rejected.
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| Privacy Consent |
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I the Applicant acknowledge that I have read the Privacy Notice of Ray White – A .J McPherson & Associates Ltd. I authorise Ray White – A.J. McPherson & Associates Ltd to collect information about me from:
- My Previous letting agents and/or landlords;
- My personal referees;
- Any Tenancy Default Database which may contain personal information about me. I also authorize Ray White Real Estate to disclose details about any defaults by me under the tenancy to which this application relates to any tenancy default database to which it subscribes including Department of Housing & Building National Tenancy Database (NTD).
I authorize Ray White – A.J.McPherson & Associates Ltd to disclose the personal information it collects about me to the owner of the property even if the owner is resident outside New Zealand and to any third parties – valuers, contractors, sales people, insurance companies, body corporates, other agents and tenancy default databases.
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* I the applicant have read and understand the Privacy Statement and Privacy Consent outlined above.
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