Bennison Mackinnon & Associates Pty Ltd - Amazon Web …



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1. Agent Details

Address: 72 Bridge Street, Benalla VIC 3672

Phone no: 03 5762 3322

Fax no: 03 5762 4334

Email: info@.au

Property Manager: Shylandi Lewis ID: 2711

2. Property Details

Address

Suburb Postcode

Lease Term Years Months

Date Property is to be occupied / /

Number of Applicants to Occupy the Property

Adults: Children: Ages:

3. Personal Details

Title First Name Initial

Last Name

Date of Birth / / Age (Years)

Drivers Licence Number State of Issue

Alternate ID (eg passport) No

Contact details

Current Address

Suburb Postcode

Home Ph Mobile Ph

Email

Occupation Work No

4. Emergency Contact

Please provide an emergency contact not residing with you

First Name Surname

Relationship Phone No

Address

Suburb Postcode

5. Social Security Benefits

Type $

Type $

Payment Cycle Weekly Fortnightly

Next payment Date / /

6. Utility Connections

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7. Declaration

I hereby offer to rent the property from the owner under a lease to be

prepared by the Agent. Should this application be accepted by the landlord I agree to enter into a Residential Tenancy Agreement.

I acknowledge that this application is subject to the approval of the

owner/landlord. I declare that all information contained in this application (including the reverse side) is true and correct and given of my own free will. I declare that I have inspected the premises and am not bankrupt. I, the tenant, accept the property in the condition it was in when inspected.

I authorise the Agent to obtain personal information about me from:

(a) The owner or the Agent of my current or previous residences;

(b) My personal referees and employer/s;

(c) Any record listing or database of defaults by tenants;

Any record listing or database of defaults by tenants such as TICA, NTD or TRA for the purpose of checking your tenancy history. I am aware that I may access my personal information by contacting:

TICA 1902 220 346

NTD 1300 563 826

TRA (02) 9363 9244

I am aware that the Agent will use and disclose my personal information

within this application in order to:

(a) communicate with the owner and select a tenant

(b) prepare lease/tenancy documents

(c) allow trades-people or equivalent organisations to contact me

(d) lodge/claim/transfer to/from a Bond Authority

(e) refer to Tribunals/Courts & Statutory Authorities (where applicable)

(f) refer to collection agents/lawyers (where applicable)

(g) complete a check with TICA

(h) transfer water account details into my name

I am aware that if information is not provided or I do not consent to the uses to which personal information is put, the Agent cannot provide me with the lease/tenancy of the premises. I am aware that I may access personal information on the contact details above.

Signed: Date / /

8. Applicant History

Do you own any Property? YES NO If Yes Where?

Current Residential Address: (As indicated in Section 3)

When did you move in to your current address? / /

Are you? Renting/ Boarding Own Property

If Renting or Boarding? Name of Landlord/Agent/Or Person you pay rent to:

Phone No:

Rent Paid Per Week $

Reason for leaving:

Previous residential address:

Suburb Postcode

Dates you lived at this address: / / to / /

Name of Landlord/Agent (If applicable):

Phone No:

Rent Paid per week $

Reason for leaving:

Did you receive any breach notices during your tenancy? Yes No

If Yes, please specify why:

Was the bond repaid in full? Yes No

If No, please specify why:

List your previous 2 addresses you have lived at with dates and contact details? (Excluding the above properties)

/ / to / /

/ / to / /

9. Other information

Do you have any vehicles? Yes No If Yes, how many:

Do you have pets? Yes No

If Yes, please specify type/breed and age:

10. If Student, please complete the following

Place of Study

Course being undertaken

Course Length

Enrolment Number

Campus Contact Ph

Course Co-ordinator Ph

11. Current Employment Details

Occupation

Employers Name

Employment Address

Suburb Postcode

Employer Phone No

Contact Name

Start of employment / /

Full Time Part Time Casual (Please Circle)

Net Income $ Per Week / Fortnight / Month (Please Circle)

12. Previous/Other Employment Details

Occupation

Employers Name

Employment Address

Suburb Postcode

Employer Phone No

Contact Name

Dates of employment / / to / /

Net Income $ Per Week / Fortnight / Month (Please Circle)

13. Professional / Character Referees

1. Reference name

Occupation

Relationship Phone No

Notes

1. Reference name

Occupation

Relationship Phone No

Notes

APPLICATIONS FOR TENANCY

PRIVACY ACT 1988

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 and to process and evaluate the application. The personal information collected about the Applicant may be disclosed for the purpose for which it was collected, to other parties, including the landlord, referees, financial institutions, other agents, third party operators of tenancy reference databases may also be disclosed to the Agent and/ or landlord. The Agent may also disclose information to other parties on the internet.

The Agent will only disclose information in this way to other parties to achieve the purposes specified above or as otherwise allowed under the Australian Privacy Principles & the Privacy Amendment Act 2012.

If the applicant would like to access his/her personal information held by the Agent, they can do so by contacting the Agent at the address and contact numbers contained in this Application. The Applicant can also correct this information if it is inaccurate, incomplete or out of date.

In the event that your application is unsuccessful your information will be destroyed by us.

Property Address:...................................................................................................

Applicant’s Name: .................................................................................................

Applicant’s Signature: ...........................................................................................

Date:....................................

A full hard copy of our Privacy Policy is available in our office or online at

To allow us to complete your application please ensure the following documents are attached or provided with your application:

( Completed Application form/s

(Any adults over the age of 18 y/o that will be residing at the property are required to complete their own application – this includes any persons not going on the lease)

( Copy of Drivers Licence or Photo ID

( Copy of Medicare Card and/or Pension Card

( Copy of proof of income

These may include any or all of the following:

• Centrelink statements

• Wage slips

• Bank statements

( Written rental references (if applicable)

( Rental payment history (if applicable)

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Residential Tenancy Application Form

For your application to be processed you must answer all questions

(Including the reverse side)

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