1.
COMPANY
Company Name ...... ACN/ABN: ......
Registered Office......
INDIVIDUAL
Full Name(s)......
Address......
Occupation......
Phone No: B…...... H ...... Fax No.: ......
Mobile No...... Email:……………………………………………….
ACCOUNTANT
Name...... Phone : ......
Address......
BANK ACCOUNT
BSB & Account Number:...... Bank : ......
Branch...... Phone : ......
Style/Name of Account......
2 TRADE REFERENCES (ie. Suppliers)
Person to Contact...... Company : ......
Address...... Phone : ......
Person to Contact...... Company : ......
Address...... Phone : ......
PRIOR LANDLORD
Name...... Phone : ......
Address of Property Leased......
BANKRUPTCY
Are you currently or have you ever been declared bankrupt, have you ever entered into any composition or arrangement for the benefit of creditors, or had a judgment made against you by creditors?
Yes / No
If the answer is yes to any of the above, please provide full details.
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
OTHER DOCUMENTATION WHICH MUST BE SUPPLIED BY THE APPLICANT/LESSEE:
1. Lessee is to provide a clear copy of photo identification which must show their residential address.
2. If the Lessee is a Company the Lessee must provide a copy of the Certificate of Incorporation and the ASIC Company search which details the Registered Office of the company and lists the Directors and Shareholders.
GUARANTOR/COVENANTOR (For companies, please include all directors)
Full Name(s): ...... Phone : ......
Address:...... DOB:...... ……......
Full Name(s): ...... Phone : ......
Address:...... DOB:…......
Full Name(s): ...... Phone : ......
Address:...... DOB:…......
PRIVACY
1.You declare that the above information is true and correct and that you have provided it to us of your own free will.
2.We will collect, use, disclose and store your personal information in accordance with the provisions of the Privacy Act 1988 (Cth).
3.We collect the information above for all relevant and related purposes to your application for tenancy and for your actual tenancy. We will use and disclose your personal information in order to
(a)communicate with the landlord;
(b)prepare lease/tenancy documents;
(c)allow tradespeople to contact you;
(d)refer matters arising in respect of your application for tenancy and your actual tenancy to Tribunals/Courts & Statutory Authorities (where applicable); and
(e)refer matters arising in respect of your application for tenancy and your actual tenancy to collection agents/financiers/lawyers/etc (where applicable).
4.You authorise us to conduct any enquires, and/or searches, including any tenancy information databases in order to verify the above information and to obtain personal information:
(a)in relation to your financial capacity;
(b)from the landlord or the agent of your current or previous residence (if applicable);
(c)from your trade references and any other relevant party; and
(d)from any record, listing or database of defaults by tenants.
5.If you default under a rental agreement, we may disclose details of that default to a tenancy default database, to our legal advisers and financial advisers, and to agents/landlords of properties you may apply for in the future.
6.Except as expressly provided for in this consent, we will not sell or otherwise disclose your personal information to a third party (other than our related companies and as described in this form), or make any other use of your personal information, for any purpose which is not incidental to your tenancy.
7.You are entitled to have access to any personal information relating to you which you have previously supplied to us and to correct any inaccuracies in respect of that information.
Signature of Applicant: ...... Date: ......
Name: ......