Application for Residential Tenancy
(One application to be completed per person)
SPACE
TENANCY
APPLICATION
Part 1 Rental
Property
Details
Item 1:
Accredited Agency
Agent Details
Agency name:
South Brisbane
Brisbane Partners
Partners
P/LACN
t/a SPACE
SPACE
Property
South
Brisbane
NICK
PENKLIS
PTY LTD
083 884
253 T/AS
SPACE
PROPERTY AGENTS
South
P/L
t/a
Property
South
Brisbane
Address:
130
Vulture Street,
South Brisbane,
QLD 4101 QLD 4064
90 LATROBE
TERRACE,
PADDINGTON
Phone:
Mobile:
07 3846
3510 4333
7600
Email: [email protected]
Item 2:
Fax:
07 3368
3844 7395
07
3937
Property Details
Property address
Rent
a week
a fortnight
Tenancy term
Starting on
a month
Bond
Insert "fixed term agreement" or "periodic agreement".
Ending on
Part
2 Applicant
Details
Applicant
Details
Item 3:
Contact Details
Full name
Date of Birth
Have you been known by any other name(s)?
Yes
If Yes, what other name(s) have you been known by?
Work phone
No
Mobile
Home phone
Email:
Driver's licence/Passport number
Number of vehicles
Item 4:
Item 5:
Item 6:
Dependants
Do you have any dependants?
Dependant full name(s)
State
Registration number(s)
Yes
Relationship to Applicant
Smoking
Are you or any of the dependants living with you a smoker?
Pets
Do you intend to keep pets at the property?
Number of pets Type of pet/s
Are your pets registered with a council?
If Yes, please state which council:
EF015 T15.8
No
08/09
Yes
No
Yes
No
Copyright REIQ
Yes
Dependant Date of Birth
No
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Item 7:
Applicants Address History
Current residential address
Period of occupancy
Type of occupancy:
Rent
Owner
Other >
Current Agent/Lessor (if renting)
Agent/Lessor phone
Current rent
$
Reason for leaving:
a week
a fortnight
a month
Previous residential address
Period of occupancy
Type of occupancy:
Rent
Owner
Other >
Previous Agent/Lessor
Agent/Lessor phone
Current rent
$
Item 8:
Reason for leaving:
a week
a fortnight
a month
Employment Details
Are you employed?
Yes
Employment status:
Occupation
Full Time
No (if no, please provide details of previous employer, if any)
Part Time
Casual
Date commenced employment (approx)
Contract
Self employed
Net income (per week)
$
Date terminated employment (if any)
Employer/Business Name
Item 9:
Address
Phone
If self employed, Accountant's Name
Phone
Centrelink Payments
Are you receiving any regular Centrelink payments?
Yes
No
Description of payment(s)
Total income (per week)
$
Date payments commenced
Item 10: Student Details
Are you studying full time?
Yes
No
Name of education institution you are currently attending
Are you an overseas student?
EF015
08/09
Yes
No
Copyright REIQ
Student Identification Number
If yes, Visa expiry date:
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Item 11: Personal References
Please do not list relatives, another applicant or partners and provide business hours contact numbers.
Referee 1
Relationship
Address
Phone/Mobile
Referee 2
Relationship
Address
Phone/Mobile
Item 12: Personal Representative
i.e. preferred person(s) to be contacted in the event of an emergency.
Representative 1
Relationship
Address
Phone
Representative 2
Relationship
Address
Phone
Supporting
Documents
Part 3 Supporting
Documents
Item 13: Identification
You are required to meet a 100 point identification criterion upon submission of your application. The
agent/lessor may photocopy any item and retain as part of your application.
Please tick the identifying documents you have provided with your application.
IMPORTANT: At least one form of Photo Identification MUST be provided.
70 Points
Passport
Full birth certificate
Citizenship certificate
Student Photo ID
Proof of age card
Department of Veterans Affairs card
State/Federal Government Photo ID
Medicare card
Telephone bill
Tenancy History Ledger
Council rates notice
Electricity bill
Bank statement
Motor vehicle registration
Gas bill
Credit card statement
Last FOUR rent receipts
Rent bond receipt
Previous tenancy agreement
40 Points
Australian driver's licence
Centrelink Card
25 Points
Item 14: Proof of Income
You are also required to supply the agent/lessor with proof of your income upon submission of your application.
Employed:
Self employed:
Not employed:
EF015
08/09
Last TWO pay slips.
Bank Statements, Group Certificate, Tax Return or Accountant's letter.
Centrelink Statement.
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Page 3 of 4
Declaration
Part
4 Declaration
Please declare the following by selecting either TRUE or FALSE
I, the Applicant,
1. have never been evicted by an agent/lessor
True
False
2. have no known reasons that would affect my ability to pay rent
True
False
3. was refunded the rental bond for my last address in full (if applicable)
True
False
True
False
1. acknowledge that my personal contents insurance is not covered under any lessor insurance
policy/s and understand that it is my responsibility to insure my own personal belongings.
Yes
No
2. understand that you as the agent/lessor have collected this information for the purpose of
determining whether I am a suitable tenant for the property - in particular to check my identification,
my ability to care for the property, my character and my creditworthiness.
Yes
No
2.1 for such purposes, I authorise you to contact the persons named in this application, and to
undertake such enquiries and searches (including tenancy databases searches) as you
consider reasonably necessary.
Yes
No
2.2 in doing so, I understand that information provided by me may be disclosed to, and further
information obtained from, referees named in this application and other relevant third parties.
Yes
No
3. acknowledge and accept that if this application is denied, the agent is not legally obliged to provide
reasons as to why.
Yes
No
4. consent 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 corporates, contractors,
other real estate agents, salespeople and tenancy default databases.
Yes
No
5. acknowledge that I have received and reviewed the General Tenancy Agreement (Form 18a),
the standard terms and any special terms before completing this application.
Yes
No
6. acknowledge that I have received or have available the Information Statement (Form 17a), body
corporate by-laws (if applicable) before completing this application.
Yes
No
7. acknowledge that I have been made aware of the agency's Privacy Policy.
Yes
No
8. acknowledge that the lessor and applicant (tenant) are bound by this agreement immediately upon
communication of either the lessor or agent's acceptance of the application.
Yes
No
9. consent to the use of email and facsimile in accordance with the provisions set out in Chapter 2
of the Electronic Transactions (Queensland) Act 2001 (Qld) and the Electronic Transactions Act
1999 (Cth);
Yes
No
10. declare that the above information is true & correct and that I have supplied it of my own free will.
Yes
If false, please advise what deductions were made from your bond?
4. have no outstanding debt to another agent/lessor?
If false, why are you in debt to your past agent/lessor?
Part 5 Acknowledgement
Please acknoweldge the following by selecting either Yes or No
I, the Applicant,
would
Direct
Connect
to assist
with connecting
your utilities
(gas, electricity
Yes
Would
youyou
likelike
Direct
Connect
to assist
youyou
in connecting
your utilities
(electricity/gas
etc.)? etc.)?Please circle
No
YES
No
NO
Name of Applicant
Signature
EF015
08/09
Date
Copyright REIQ
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