Pre-tenancy application form
Please complete this form to apply for the tenancy at the address below. The information you provide is for applying for
this tenancy and may be used for a credit and reference check. Your privacy is protected under the Privacy Act 2020.
Tenancy details
Property address:
Commencement of tenancy: Date: / /
Applicant details
Full name: Date of birth: / /
Phone number: Mobile phone:
Email:
Current address:
How long have you lived there? Years: Months:
Please state why you are leaving this address:
Identification
Please provide photo identification, such as your driver’s licence.
Driver’s licence number: Version no.
(if applicable)
NB. Provision of this number is voluntary and will only be used to verify your identity and for carrying out a credit check
Alternative form of ID:
Current landlord’s details
If you are currently renting, please provide your landlord’s name and contact details.
Landlord’s name:
Phone number: Mobile phone:
Email:
May I contact this person for a reference?
Yes No (please tick)
Tenancy
References
Please provide two referees that I can contact. Referees can be a friend, co-worker, your employer or someone who
knows you well.
One of your referees should be able to provide a reference about your creditworthiness. If you have already provided
your current landlord’s details, only one additional referee is needed. Please let these people know I may be contacting
them for a reference.
Referee name 1: Phone:
Email:
Referee name 1: Phone:
Email:
Signature:
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 informaion 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 that the credit reporting agency:
› may hold my information on their credit reporting database and use it for providing credit reporting services, and
they may disclose my information to their subscribers for the purpose of credit checking or debt collection; and
› as part of providing a credit report, may check the Ministry of Justice fines database for any overdue fines
Imayhave.
Signed: Date signed:
Under the Privacy Act 2020, you have the right to ask for a copy of all information held about you, and have the right
torequest the correction of any incorrect information.
Tenancy
