Tenancy Application Form

  • Please note one application must be filled in for each person over the age of 18 years intending on living in the property.
  • Your application will not be processed until you have supplied photo id.
Property Details
Address of the property you wish to apply for 
Lease commencement date  
Lease term

Number of people occupying the property

  Adults         Children
If successful is there a specific day you would like to pay the rent?         
If there is please specify here   on a   
  or a specific day of the month (please choose day) 
Do you have any pets?          Are they desexed?     
   If yes please state type 
   
Personal Details  
Given name(s)
Surname
Date of birth              
Current address Street
  Suburb
  City
Previous address Street
  Suburb
  City
Phone numbers Home
  Work
  Mobile
  Fax
E-mail address
Drivers licence number 5a
  5b
Car Make & Model
  Registration Number
Passport number
Super Gold card number
Names of other applicants that go with this application
   
Next of Kin (Must be a New Zealand Contact, not living at the same property.  This will be used as your address for service)  
Given name(s)
Surname
Relationship to you
Address Street
  Suburb
  City
Phone number Home
  Mobile
E-mail address
   
 Current Tenancy Details or Ownership History  
Lenght of time at current address  Years    Months
Rent paid per week
Reason for leaving
Name of landlord/ selling agent
Phone number
   
Previous Rental History or Ownership History  
Previous address
Lenght of time at above address   Years     Months                       
Rent paid per week
Name of landlord/ selling agent
Phone number
   
Current Employment  
Occupation (If you are a beneficiary please state)
Current empolyer
Employers address Street
  City
Contact name (Pay roll / Manager / WINZ Case Worker)
Contact number
Length of employment   Years     Months      
Net Income
   
Self Employment Details
Company Name
Business Type
Business Address Street
  City
Position Held
Accountant Name

Phone Number
Net Income (per annum)
   
Previous Employment
Occupation
Employers Address Street
  City
Contact Name (pay roll/manager)

Contact Number

Length of Employment    Years       Months       
Net Income (per annum)
   
Study Details
Place of Study
Course Name
Course Length    Years        Months       
Enrolment/Student Number
   
Referees
Referee Name
Relationship to you
Home/business phone number
Mobile phone number
   
Referee Name
Relationship to you
Home/business phone number
Mobile phone number
   
Please also answer the following
Have any of your previous tenancies been terminated?

Are you in debt to another lessor or agent?
Is there an existing reason that may affect your rent payments?
If yes, please provide details
   
Privacy Statement

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.
Privacy Consent

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:

  1. My Previous letting agents and/or landlords; 
  2. My personal referees;
  3. 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.

*  I the applicant have read and understand the Privacy Statement and Privacy Consent outlined above.