1^st Applicant:                

Name……………………………………………………………………………………………………….....................................

Address……………………………………………………………………………………………………....................................

Home Phone………………………………..Mobile………………………………………………….....................................

  2^nd Applicant:                     

Name…………………………………………………………………………………………………………................................ 

Address……………………………………………………………………………………………………..................................

Home Phone………………………………..Mobile…………………………………………………….................................

Occupation……………………………………………………Income………………………………….................................

Employer………………………………………................Work Phone……………………………................................

Date of Birth.........................Drivers License No………………………………………………................................

Dependants:

Name……………………………………………….Age……………………………………………………...............................      

Name……………………………………………….Age……………………………………………………...............................

Name……………………………………………….Age……………………………………………………...............................

Name……………………………………………….Age…………………………………………………… ........................................

Are you currently renting?....yes/no…
How long…………Weekly Rent………………………………...........................................................................

If less than 12 months, Name of previous Agent…………………………………………………………......................
Period of tenancy………………………..Reason for leaving……………………………………………….......................

Tenancy References: 1……………………………..........................Phone………………………………....................

                               2……………………………..........................Phone.………………………………...................

Car Rego No…………………………………………………………………………Pets.………………………….....................

Relative/Person to contact in case of emergency………………………………………………………….....................     
Relationship…………………………………………………Phone…………………………………………………....................
Preferred location………………………………….No. of bedrooms…………………………………………......... ...........    
Max Rent…………..Expiry date of current lease……………………………………………………………......................
Other requirements…………………………………………………………………………………………………..................... 
………………………………………………………………………………………………………………………………................... 
………………………………………………………………………………………………………………………………...................  
………………………………………………………………………………………………………………………………...................
You will be required to provide copies of the following forms of ID:Photocopy of drivers license or
18+card or passport, Tenancy rental history eg: Written tenancy reference,
Proof of income eg: pay slip, centrelink statement, bank statement, Power or Phone account 
I/we the above applicant(s) do solemnly and sincerely declare that the above information is true and correct.  
APPLICANT(S) SIGNATURE

.......................................................................................................................................................                                                          Date:      / /