Tenancy Application Form
Unit 5/57 St Ann Street, Merrylands 2160
This is an application form to apply for tenancy in the above unit. Please fill out the form and provide evidence (list at
end of form) for the below information. Form can be filled out electronically or hand written. IF you are successful, you
will be contacted to finalise.
If you have any questions, please contact Rebecca on [email protected]. Once complete please return
form via email.
Occupant 1 (principal tenant):
Full name Date of birth Passport number, expiry, country
Citizen, Permanent Resident or Visa type Mobile Email
Note the length & expiry of visa
Other Proposed Occupants:
# Full name Date of birth Citizen, Permanent Relationship to
Resident or Visa Occupant 1
type
2
Occupant 1:
Residency Current Residence Previous Residence
Street address
Owner or agent name
Owner or agent contact number &
email
Rent paid/week
Dates of residency
Reason for leaving
Employment Current Employment Previous Employment
Occupation
Employed by
Employment status
e.g., permanent, casual, full time,
part time etc.
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Street address
Employer’s contact name
Employer’s contact number & email
Monthly gross pay
Dates of employment
References & Emergency Reference #1 Reference #2 Next of Kin / relative
Contacts
Name
Street address
Contact number & email
Relationship to you
By signing this application, you grant us permission to communicate with all the contacts. If you abandon the tenancy
and possessions for any reason then you grant us permission to allow your relative listed above to remove all
contents of the dwelling on your behalf.
Occupant 2:
Employment Current Employment Previous Employment
Occupation
Employed by
Employment status
e.g., permanent, casual, contract, full
time, part time etc.
Street address
Employer’s contact name
Employer’s contact number & email
Monthly gross pay
Dates of employment
All occupants:
Vehicles (if applicable) Car #1 Car #2
Registration number
Make & model
Colour
Pets (if applicable)
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When would you be able to move in?
How long would you like to stay in this unit?
Note the number of months/years
Have you ever been served a late rent notice?
Have you ever been served an eviction notice?
How much rent are you willing to pay weekly?
Any other comments?
Agreement & Authorisation
I believe the statements I have made are true and correct. I hereby authorise verification of information I provided and
communication with any and all names listed on this application. I understand that any discrepancy or lack of
information may result in the rejection of this application. I understand that this is an application for tenancy and does
not constitute a rental or lease agreement in whole or part.
I have attached the below documents for all occupants:
o Current passport
o Driver license/Identification card
o Current bank statement (showing transactions)
o Two most recent pay slips
o First 2 pages of current lease
Please note, applications not completed fully or without the above evidence will not be considered.
Note: pictures and electronic signatures will be accepted.
Occupant 1:
Signature: _______________________________________________________ Date: /05/2023
Print full name: _______________________________________________________
Occupant 2:
Signature: _______________________________________________________ Date: /05/2023
Print full name: _______________________________________________________
Version 3, May 2023
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