Rental Information General Details Name Date of Birth Drivers Licence State Martial Status Motor Vehicle Registration

Which state: Do you smoke? Do you have a pet? Maintain a garden? Phone numbers Mobile Work Home e-mail Current Details Home Address Rent $ How Long: Landlord Landlord No Date to be vacated Reason for leaving Bond refunded? If no, why? Previous Details Address Rent $ How Long Previous Landlord Phone No.: ( ) Reason for leaving Bond refunded? If no, why? Gross Income Weekly Fortnight Monthly Annual Net Income Week Fortnight Month Year Current Employment Occupation $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Employer's Name Phone No.: Duration Contact Name Contact number Previous Employment (1) Occupation Employer's Name Phone No.: Duration Contact Name Contact number Previous Employment (2) Occupation Employer's Name Phone No.: Duration Contact Name Contact number Personal References (NOT RELATIVES) Name Relationship How long? Ph No.: Address Name How long? Relationship Ph No.: Address Name Relationship How long? Ph No.: Address Name How long? Relationship Ph No.: Address Emergency Contacts Name Ph No.: Address Relationship

Next of Kin / Family Contact Name Ph No.: Address Relationship Nominated Agent Name Relationship Phone Number Residential Address Proof of Identity [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] Current Photo ID (Drivers Licence) Current passport Recent Pay Slips Phone/Gas/Electricity Bank Statements / Other official correspondence Written references Rent payment history

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