Premises Address of Premises Applied for :
Proposed Commencement Date:
Proposed Lease Term:PLEASE SELECT6 MONTHS12 MONTHS24 MONTHS
Proposed Rent Per Week:
Full Name:
Date:
Present Address:
Postcode:
Phone Work:
Mobile:
Phone Home:
Fax:
Email:
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Vehicle Registration No:
Drivers Licence No:
Passport No:
Passport Expiry Date:
Bank or Building Society:
Branch:
BSB:
Account Number:
Nearest Relative Not living with you:
Referee 1 – Name:
Phone:
Referee 2 – Name:
Occupation:
Date Commenced:
Employers Name:
Employers Address:
Previous Occupation:
Date Finished:
Previous Employers name:
Previous Employers Address:
Name of present Landlord / Agent:
How long at this address:
Current rent paid $:
Name of previous Landlord / Agent:
Address of previous Premises rented:
Number of persons who will occupy premises
Adults:
Children:
Ages:
Pets:YesNo
[group group-877]
Pets Type:
[/group]
Smoker(s):YesNo
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Id Drivers Licence or Passport
Bank Statement
Payslip
Tenancy ledger
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