Monday, August 29, 2022
Rental Property Details.
Barry Plant Office Belmont
Agent / Consultant Barry plant
Full address of property 5 cloudbreak street
Armstrong creek, Victoria, 3217
Residential Rental Application.
Please note: We are unable to process applications unless the renter has inspected the property, completed the
application form in full, provided copies of 100 points of identification and accepted the terms and conditions in the space
provided on the last page.
Should you require any assistance, please contact our office.
Every adult applying for this property must individually complete a separate application.
Date property inspected Sunday, August 28, 2022
Preferred commencement date Friday, September 23, 2022
Is there is another property you would like to
rent through Barry Plant as a second No
preference?
Preferred lease term 12 month or 2 yrs
Rental amount 470
Do you accept the property in its current
condition?
Yes
Number of Children 1
Ages of Children (if applicable) 16
Are there other adults applying to reside with
you?
No
1
Please note: all adults that will reside at the property must complete an application form
Do you have pets? No
Please note: Written consent to keep any pets at the rented premises must be obtained.
Applicant Details
Reminder: (Every adult applying for this property must individually complete a separate
application)
Full Name James Robert Hammond
Current address 19 Monterey street
Armstrong creek , Victoria , 3217
How long did you live at the address? 10 months
At your current address, are you the: Renter
Monthly rent paid 1800
Reason for leaving? Move to a bigger house with yard space .
Rental provider/Agent details for this
property:
Agent
Agency (if applicable) Avenue five
Agency Contact Name Eleisha Jackmon
Agency Phone Number 0448 885 330
Applicant Mobile no. 0476 212 901
Date of birth Wednesday, December 11, 1985
Drivers Licence No. 060604000
2
Licence expiry date Saturday, May 10, 2025
State of issue Victoria
Vehicle / Motor Bike / Boat / Trailer Ytr 492
Registration Numbers
Employment History.
Please provide your current employment details.
Employment Status Full Time
Occupation Wire worker
Employer Infrabuild
Contact person James mccredon
Employer address Madden avenue
North shore , Victoria , 3214
Office phone (landline) 0439 752 544
Length of employment 3
(Years)
8
(Months)
Net monthly income $5100
Previous employer Hicks transport
Previous occupation Diesel mechanic
Previous employer address Karook street
Cobram , Victoria , 3644
Office phone (landline) 0448 300 039 Kevin
Length of Employment 2
(Years)
7
(Months)
Net Monthly Income $6000
3
Self Employed.
Student.
Please provide details of your Parent/ Guardian/ Sponsor below
Please provide details of any additional income/ centrelink payments
Amount received per fortnight $450
Source of additional income Family tax benefit
Upload additional income / Centrelink
statement
pdf
Income State…
Contacts / References.
Please provide a professional character reference
Name Jacinta Kapelle
Relationship to you Friend
Phone numbers 0403864941
Email [email protected]
Please provide a personal character reference
Name Ryan Swan
Relationship to you Friend
Phone numbers 0404 331 459
Please provide in case of emergency contact -next of kin details that we may contact
Name Tnaya Hammond
Relationship to you Daughter
Phone numbers 0427763684
Email [email protected]
4
Address 19 Monterey street
Armstrong creek , Victoria , 3217
YES
I consent to the RRP/ Agent contacting my
next of Kin in an emergency relating to my
wellbeing or the property
Identification
Please provide us with at least 100 Points of Identification (attach copies). Original ID used to prepare application
must be sighted prior to signing leases.
You will not be able to submit this form until 100 points, including at least 1 peice of photo ID is provided.
Drivers licence - 25 points YES
Upload drivers licence
Utilities - electricity - 20 Points YES
Upload - utilities - electricity
pdf
93ced915-0.p…
Utilities - other - 20 points YES
5
Upload - utilities - other
Proof of Rental payments - 20 points YES
Upload - Proof of rental payments
Medicare card - 20 points YES
Upload medicare card
TOTAL POINTS PROVIDED 105
Utility Connections.
6
YourPorter is a free service connecting utilities and other services.
If the Agent approves this application, YourPorter will connect your water for the purpose of usage charges
at your new property on behalf of the Real Estate Agent.
YourPorter will be contacting you by phone, SMS, or email for the purposes of assisting you to connect your utilities
within 24 hours of receiving this application for next business day connection.
Telephone: 1300 400 600
Fax: 1300 326 468
www.yourporter.com.au
Connections Required Water
DECLARATION OF ACCEPTANCE:
I/We consent to the disclosure of this application form (including any personal information contained in this form) to YourPorter Pty Ltd
(ABN 36 252 576 050) for the purpose of allowing YourPorter and its service providers to contact me for the connection of services as
offered by YourPorter.
I/We acknowledge that if I/We do not provide my/our personal information, YourPorter will not be able to provide these services to me/us.
YourPorter will ensure that my/our personal information is collected, used, held and disclosed in accordance with the requirements of the
Privacy Act 1988 (Cth).
I/We acknowledge that YourPorter may receive a benefit in relation to the connection of any of the services listed above. I/We consent to
YourPorter contacting me by phone or SMS in relation to the connection of the services listed above. I/We acknowledge that this consent
permits YourPorter to contact me even if the numbers listed on this application are listed on the Do Not Call Register. YourPorter will
otherwise collect, hold, use and disclose personal information in accordance with their respective privacy policies, which are available at
www.yourporter.com.au/general/privacy-policy/. YourPorter is a free service, but l/We acknowledge that standard connection fees may
apply for services connected (in addition to the ongoing service fees).
I/We acknowledge that neither YourPorter nor the Agent accept any responsibility for any delay in or failure to arrange or provide for any
connection of a service or for any loss, damage, cost or expense in connection with such delay or failure. By signing this application I/We
understand YourPorter is a value add product and that I/We are under no obligation to use YourPorter.
Signature to authorise YourPorter to
contact you in relation to your water
connection and any other requested
utilities.
Date of Signing Monday, August 29, 2022 18:37
FORM 3
Residential Tenancies Act 1997
(Section 29C)
7
(Regulation14)
STATEMENT OF INFORMATION FOR RENTAL APPLICANTS
1. Discrimination is treating, or proposing to treat, someone unfavourably because of a personal
attribute. Discrimination is also imposing an unreasonable requirement, condition or practice
that disadvantages persons with a personal attribute.
2. In Victoria it is unlawful to discriminate against someone in relation to certain personal
attributes. This means that residential rental providers (rental providers) and real estate agents
cannot refuse you accommodation or discriminate against you during your tenancy on the basis
of personal attributes protected by law. The following is a list of some protected attributes that
are sometimes discriminated against in the rental market - age;
disability (including physical, sensory, intellectual disability and mental illness);
employment activity;
expunged homosexual conviction;
gender identity;
industrial activity (including union activity);
marital status;
parental status or status as a carer;
physical features;
political belief or activity;
pregnancy or breastfeeding;
race;
religious belief or activity;
lawful sexual activity or sexual orientation;
sex or intersex status;
association with someone who has these personal attributes.
3. These personal attributes are protected by law and extend to agreements under the Residential
Tenancies Act 1997 (the Act). It is against the law for a rental provider or their agent to treat you
unfavourably or discriminate against you because of these personal attributes when you are
applying for a rental property, occupying a rental property or leaving a rental property.
4. Discrimination on the basis of any of these personal attributes may contravene Victorian laws
including the Act, the Equal Opportunity Act 2010 (the Equal Opportunity Act), and a range of
Commonwealth Acts including the Age Discrimination Act 2004, the Disability Discrimination Act
1992, the Racial Discrimination Act 1975 and the Sex Discrimination Act 1984.
5. In some limited circumstances, discrimination may not be unlawful, including accommodation
provided for children, shared family accommodation, and student accommodation. For example,
a community housing provider who is funded to provide youth housing may positively
discriminate to provide accommodation for a young person. For more information, contact the
Victorian Equal Opportunity and Human Rights Commission (VEOHRC).
6. Scenarios and examples of unlawful discrimination in applying for a property Refusing or not
accepting your application because you have children, unless the premises is unsuitable for
occupation by children due to its design or location.
Processing your application differently to other applicants and not giving your application
to the rental provider because you have a disability or because of your race.
Offering you the property on different terms by requiring more bond or requiring you to have
a guarantor because of your age.
Refusing to provide accommodation because you have an assistance dog.
7. Scenarios and examples of unlawful discrimination when occupying or leaving a property
Refusing to agree to you assigning your lease to someone else because of that person’s personal
attributes.
Refusing to allow you to make reasonable alterations or modifications to the property to
meet your needs if you have a disability.
Extending or renewing your agreement on less favourable terms than your original
agreement based on your protected attributes (e.g. due to a disability).
Issuing you with a notice to vacate based on your protected attributes.
8
The examples listed and similar actions could contravene the Act, the Equal Opportunity Act, or the
Commonwealth Acts.
Getting help
8. If a rental provider or a real estate agent has unlawfully discriminated against you and you have
suffered loss as a result, you may apply to VCAT for an order for compensation under section
210AA of the Act. VCAT may be contacted online at vcat.vic.gov.au/ or by calling 1300 018 228.
9. If you would like advice about unlawful discrimination in relation to an application to rent or an
existing agreement you may call Victoria Legal Aid on 1300 792 387.
10. If you feel you have been unlawfully discriminated against when applying to rent, or once you
have occupied a property, you or someone on your behalf may make a complaint to VEOHRC at
humanrightscommission.vic.gov.au/ or by calling 1300 292 153.
Terms and Conditions.
The information contained in this form is being collected by the Barry Plant Group Pty Ltd ABN 96 088 069 952, and
the various real estate agents, agent’s representatives operating under the Barry Plant trademark (“Barry Plant”) so
that we can consider your application to rent a property.
It is a condition of this application that you consent to the collection and use of the information contained in this
application in the manner outlined in our Privacy Policy found at www.barryplant.com.au/ privacy-statement
If you provide us with personal information of other parties (such as a joint tenant, an emergency contact or your
referees) you must notify them that you have provided their personal information to Barry Plant and must make
them aware of our terms and conditions contained herein and Privacy Policy.
The applicant/s acknowledges that this is an application for lease of this property and that the application is
subject to the owner’s approval and the availability of the premises. No action will be taken against the owner
/agent if the application is unsuccessful.
Acceptance of Terms.
I declare that:
I have inspected the premises;
The information I have provided in my application is complete and accurate in all respects;
I am not, and have never been, a bankrupt;
I have been informed that Barry Plant may use the services of tenancy database operators set out below to check
the tenancy history of applicants; National Tenancy Database - Ph 1300 563 826, www.ntd.net.au TICA - Ph 1902
220 346, www.tica.com.au
If I default under a rental agreement, I authorise Barry Plant to disclose details of any such default to the tenancy
database operators National Tenancy Database and/or TICA and to landlords or agents for any properties I may
apply for in the future, in accordance with Section 439 of the Residential Tenancies Act (1997);
I authorise Barry Plant, its authorised agents and staff to use and / or disclose my personal information for the
following primary purposes: To undertake reference checks with referees, my employer, former employers, my
current and former landlords and/or their agents and the operators of the National Tenancies Databases detailed
above;
To enable owners of the premises to make a decision on my application;
To prepare the rental documents;
To enable tradespeople/maintenance personnel to contact me, if required;
To undertake and/or enforce legal process/decisions of a Tribunal/Court and/or Statutory Authority, where
applicable;
To instruct collection agents or lawyers, where applicable;
To transfer water account details into my name.
9
Declaration & Acceptance.
I confirm my acceptance of the terms and conditions of this rental application. I declare that all
information I have provided in my application is complete and accurate in all respects.
Full Name James Hammond
Date of Signing Monday, August 29, 2022 18:37
Signature
10
