Residential Tenancy Application

1. Property Address
2. Property Address Line 2
1. Move in Date:
2. Length of Tenancy:
3. Rent per Week:

1. First Name:
2. Last Name:
1. Date of Birth:
2. Age:
1. Hone Phone:
2. Work Phone:
3. Mobile:
1. Email Address:
1. New Zealand Residence: YESNO
2. Length of Time you have Lived in NZ: :
1. Passport No:
2. Drivers License No:
2. Upload Scaned ID provided above (File types: pdf, doc, jpg and jpeg. File limit: 2mb):
1. Vehicle Make & Model:
2. Registration No:
1. Smokers: YESNO
2. Children: YESNO
3. Pets: YESNO
3. Current Address
4. Current Address Line 2
1. Length of Time at Current Address:
2. Type: ---RentedOwnedFamilyHomestay
5. Reason for Leaving
1. Landlord /Agents Name:
2. Rent per Week:
1. Contact Number:
2. Mob:
6. Previous Address
7. Previous Address Line 2
1. Length of Time at Previous Address:
2. Type: ---RentedOwnedFamilyHomestay
8. Reason for Leaving
1. Landlord /Agents Name:
2. Rent per Week:
1. Contact Number:
2. Mob:

1. Total Number of People to stay 12345+
2. Names of Additional Occupants
1. Name:
2. Age:
3. Occupation:
4. Phone No:
1. Name:
2. Age:
3. Occupation:
4. Phone No:
1. Name:
2. Age:
3. Occupation:
4. Phone No:
1. Name:
2. Age:
3. Occupation:
4. Phone No:

1. Name of Current Employer:
2. Position:
1. Employment Address
2. Employment Address Line 2
1. Work No:
2. Length of Employment:
1. Manage Name:
2. Gross Weekly Income:

1. Emergency Address
2. Emergency Address Line 2
1. Relationship:
2. Contact No:

I authorise the Landlord/Property Manager to:

• • Collect, retain and use this information for the purpose of assessing my creditworthiness and suitability for the tenancy; and
• • Disclose information about me, whether collected from me directly or from any other source, to any other credit provider or any credit reporting agency for the purposes of providing or obtaining a credit report (which will involve the credit reporting agency providing information about me to the Landlord/Property Manager)

I understand:

If I sign a tenancy agreement with JP Properties they will keep a record of the information.If I fail to comply with the terms of the agreement JP Properties will pass information about me to a credit company.

1. Date

Under the Privacy Act 1993, you have the right to ask for a copy of all information held about you, and have the right to request the correction of any incorrect information.