PROPOSED PROPERTY ADDRESS

1st*

2nd

DETAILS

Name:*

*

DOB:*

Drivers License or 18+ Card:*

Passport No:

Home Number:

Mobile:*

Work Number:

Email:*

Total number of Occupants to reside at property:*

Please enter a number from 1 to 100.

Have you any dependants:*

Yes
No

Name & Age of Dependants:

Registration Number of Vehicle/s:

Number of Vehicles:

Please enter a number from 1 to 100.

Do you Have Pets?*

Yes
No

Pet/s Type | Breed | No. of*

Are you a smoker*

Yes
No

HISTORY

Current Address:*

Period of Occupancy:*

(Please Select)*

Renting
Owned
Other

If renting Weekly Rental Amount:*

Reason for leaving:*

Name of Agent/Lessor/Owner:*

Phone:

(If less than 2 years) Address:

Period of Occupancy:

Name of Agent/Lessor/Owner:

Phone:

Have you ever been evicted from a premises?*

Yes
No

Do you currently owe money to any landlord or agent?*

Yes
No

OCCUPATION / PROOF OF INCOME

YOU WILL NEED TO PROVIDE - PROOF OF INCOME for your application to be processed

Employed: Last TWO payslips. Self Employed - Bank Statements, Accountants Letter, and Tax Returns. Unemployed: Centrelink Satement.

Income Upload (jpg, gif, png, pdf) - less than 8MB*

Drop files here or

Current Occupation*

Length of Employment:*

Employer:*

Contact:*

Address:

Phone:*

Net Weekly Income:*

Previous Occupation:

Length of Employment:

Employer:

Contact:

Address:

Phone

REFEREES

(Referees are not related to you)

Business Referee:

Phone:

Relationship:

Business Referee:

Phone:

Relationship:

Personal Referee:*

Phone:*

Relationship:*

Personal Referee:*

Phone:*

Relationship:*

EMERGENCY CONTACT

(This information is required in case we need to contact you as a matter of arising from your tenancy and your normal contact details are not responding)

Next of Kin:*

Phone:*

Address:*

Mobile:*

Other:*

Phone:*

Address:*

Mobile:*

100 POINTS OF IDENTIFICATION -

Prior to any application being considered each applicant must produce 100 points of ID and the agent may photocopy any item and retain as part of your application

10 Points:

Medicare Card, Birth Certificate, Motor Vehicle registration Papers

30 Points:

Bank Statements, Recent Utility Accounts eg: phone, electricity or gas

40 Points:

Drivers License, Passport, 18+ Card, Photo ID Last FOUR rent receipts & tenant ledger

Upload (jpg, gif, png, pdf) - less than 8MB each*

Drop files here or

DISCLAIMER / AUTHORITY -

I, the said applicant, do solemnly declare that the information contained in this application is true and correct and that all of the information was given of my own free will. I further authorise the letting agent to contact and or conduct any inquiries and or searches with regard to the information and reference supplied in this application. I understand and agree to the conditions listed below numbered 1 to 8 and declare that I have legal capacity to enter into a Residential Tenancy Agreement.

Inspected property located at

1.

*

I Have
I Have not

inspected the property located at:

Rent the aforementioned property commencing on*

Rental period*

Rental price*

2. I have of my own accord decided that I wish to rent the aforementioned property commencing on For a period of , the rental of the property is to be per week and that this rental is within my means to support. The rental for the said property is to be paid every 2 weeks in advance at all times.

Rental bond*

3. The Bond of the aforesaid property will be and I undertake to pay the said Bond and two (2) weeks rent by cash/bank transfer or bank cheque on or before commencement start date of the Tenancy Agreement.

4. The acceptance of my application is subject to a satisfactory report being obtained from information supplied on this Tenancy Application, submitted by me

5. Should there be a requirement to commence proceedings for recovery of rent arrears, cleaning, repairs or damages to the aforesaid property during the term or expiration of the Tenancy Agreement, all cost associated with these proceedings shall be able to be recovered from me.

6. If this application is not accepted, the agent is not required or obligated to disclose why or supply to me any reason for the rejection of the application

7. Should this application be unsuccessful, all information will be destroyed following the decision to refuse accommodation.

8. I acknowledge that any false information I provide in this application could jeopardise the application and any subsequent tenancy agreement I enter into on approval by the lessor or Agent.

PRIVACY ACT ACKNOWLEDGEMENT

In accordance with the Privacy Act I authorise you to give information to and obtain information from all credit providers and references named in this application. I understand this can include information about my credit worthiness credit standing, credit history or credit capacity. I understand this information may be used to assess my application.

The personal information the prospective lessee/tenant provides in this application or collected from other sources is necessary for the Agent to verify the applicant’s identity, to process and evaluate the application and to manage the tenancy. Personal information collected about the applicant in this application and during the course of the tenancy, if the application is successful, may be disclosed for the purpose for which it was collected to other parties including the lessor/s, referees, other agents and third party operators of tenancy reference databases. Information already held on tenancy reference databases may also be disclosed to the Agent/Lessor.

If the applicant enters into a Residential Tenancy Agreement and if the applicant fails to comply (or defaults occurs) with their obligations under the agreement, that fact or other relevant personal information collected about the application during the course of the tenancy may also be disclosed to the lessor, third party operators of tenancy reference databases (eg TICA) and or other agents.

If the applicant would like access to personal information the Agent holds, they can do so by contacting Blacks Real Estate at43 Wood Street, Mackay. The applicant can also correct this information if it is inaccurate, incomplete or out-of-date. If the information is not provided, the Agent may not be able to process the application and manage the tenancy

Please select Yes or No and Initial

The applicant agrees that this is not a binding agreement – the property is deemed to be accepted when the Lease (Form 18A – and all standard terms and special terms) have been read and is signed by both parties)*

Yes
No

The applicant confirms that they have read and understand the above disclaimer authority & privacy act acknowledgment*

Yes
No

The applicant also consents and understand that should my tenancy be accepted and upon commencement of the tenancy agreement there may be cause for the agent / lessor to pass my details onto others which may include (but is not limited to) insurance companies, body corporate, contractors, other real estate agents, salespeople and tenancy default databases.*

Yes
No

Name*

Signature*

Date*

PRIVACY NOTICE AND CONSENT

I,*

full name

of,*

Residential Address

have read and understood the attached information. I authorise employees of Blacks Real Estate, and independent contractors of Blacks Real Estate including their directors, officers and employees, to obtain relevant information from, and release relevant information to, the parties described on page 2 to assist with my involvement with Blacks Real Estate. I understand that I can revoke my authority at any time. I acknowledge that if I revoke my authority, or if I decline to provide information as requested by Blacks Real Estate, Blacks Real Estate may be unable to provide the products or services I have requested.

Signature

Date:

Parent/Guardian Signature (if under 18 years of age)

RENTAL REFERENCE

In accordance with current Privacy Policy I/We the undersigned authorise the recipient of this email to give information to Blacks Real Estate regarding my/our rental history. I/We understand this information will be used to assess my/our application.

Date*

Tenants:*

Signature*

Property Address:*

Managing Agent:*

Phone:*

Was the applicant listed as the lessee? Yes No
How much was the rent per week?
How long was the lease?
Are the applicants still living there? Yes No
Was their bond refunded in full? Yes No
Were the applicants ever in arrears? Yes No
Were there any form 11’s issued (how many/why)?
Were there any form 12’s issued (how many/ why)?
Have court applications or Tribunal orders been applied for? Yes No
Did the applicants have pets? Yes No
What were they and how many?
Did the animals damage anything? Yes No
Were inspections carried out? Yes No
Was there any damage noted at the property? Yes No
Was the property kept neat and tidy? Yes No
Were the grounds maintained? Yes No
Did the applicants have any boats or extra cars on the property? Yes No
Were there any complaints by neighbours at the property? Yes No
Were there any problems at the property? Yes No
Did you find the tenants to be reliable and honest? Yes No
Would you rent to them again? Yes No

Privacy Notice and Consent

I,*

full name

of*

Residential Address

have read and understood the attached information. I authorise employees of Blacks Real Estate, and independent contractors of Blacks Real Estate including their directors, officers and employees, to obtain relevant information from, and release relevant information to, the parties described on page 2 to assist with my involvement with Blacks Real Estate. I understand that I can revoke my authority at any time. I acknowledge that if I revoke my authority, or if I decline to provide information as requested by Blacks Real Estate, Blacks Real Estate may be unable to provide the products or services I have requested.

Signature*

Date*

Parent/Guardian Signature (if under 18 years of age)

PRIVACY POLICY

Blacks Real Estate Pty Ltd (ACN 009972016) trading as Blacks Real Estate is committed to protecting your privacy in compliance with the Privacy Act 1988 (Cth) and the Australian Privacy Principles (APPs). This document sets out Blacks Real Estate’s condensed Privacy Notice. Blacks Reals Estate also has a full Privacy Policy, which contains information about how you can complain about any breach by Blacks Real Estate of the APPs or an applicable APP Code. A full copy of our Privacy Policy can be accessed here.

INFORMATION COLLECTION, USE AND DISCLOSURE

During the course of your involvement with Blacks Real Estate, we may collect, use or disclose personal information about you for the following purposes:

Assisting you to sell your property;
Assisting you to purchase a property;
Assisting you to lease a property (either as lessor or lessee);
Assisting you to obtain a loan;
Assisting you with payment or refund of a bond;
Assisting you with tenancy disputes;
Coordinating repairs or maintenance of a property owned or leased by you;
Recording or accessing information at the Titles Registry Office or other government agency;
Recording or accessing information at the Residential Tenancies Authority;
Recording or accessing information on tenancy information services or databases;
Client and business relationship management;
Marketing of products and services to you;

The types of personal information we may collect, use or disclose about you includes bu is not limited to:

Your full name;
Your date of birth;
Your residential address;
Your postal address;
Your email address;
Your home telephone number;
Your work telephone number;
Your mobile telephone number;
Your occupation and business address;
Financial information including details of your employer, income, name of bank or financial institution;
Details of your spouse, de facto, dependent children and roommates;
Details of properties owned by you;

In order to provide product and services to you, we may disclose your personal information to the persons/ organisations described below:

In the event that you are a seller or a lessee, we may disclose your personal information to prospective buyers of the property owned or leased by you;
In the event that you are a buyer or a lessee, we may disclose your personal information to the sellers of the property you are purchasing or leasing;
Your legal advisor(s) and the legal advisor(s) representing the other party(s) involved in your transaction;
Your financial institution and/ or financial advisor;
Insurance providers and brokers;
Utility providers and utility connection service providers;
Persons or organisations involved in providing, managing or administering your product or service including independent contractors engaged by us as real estate agents;
Tradespeople engaged by us to repair or maintain a property owned or leased by you;
Organisations involved in maintaining, reviewing and developing our business systems, procedures and infrastructure including maintaining or upgrading our computer systems;
Persons or organisations involved n purchasing part or all of our business;
Our related companies;
Organisations involved in the payments systems including financial institutions, merchants and payment organisations;
The Titles Registry Office or other government agencies;
The Residential Tenancies Authority;
Police;

Do you have another applicant to add to your application*

Yes
No

Please fill in the below information for the additional applicant

Name*

First Last

D.O.B.*

Do you have another applicant to add to your application*

Yes
No

Please fill in the below information for the additional applicant

Name*

First Last

D.O.B.*

Rental Application Form

PROPOSED PROPERTY ADDRESS

DETAILS

HISTORY

OCCUPATION / PROOF OF INCOME

REFEREES

EMERGENCY CONTACT

100 POINTS OF IDENTIFICATION -

10 Points:

30 Points:

40 Points:

DISCLAIMER / AUTHORITY -

PRIVACY ACT ACKNOWLEDGEMENT

PRIVACY NOTICE AND CONSENT

RENTAL REFERENCE

Privacy Notice and Consent

PRIVACY POLICY