www.palmerstonnorth.ljhooker.co.

nz
Email: rentals@ljhookerpn.co.nz
219 Broadway Avenue, PALMERSTON NORTH
Phone: (06) 354 5410
Fax (06) 355 1660
Lynda Grimley
Lynda Knight
Mobile 027 680 6426
Mobile 027 483 2202
Property Manager
Property Manager

MANAWATU (1994) LTD MREINZ

Licensed under the Real Estate Agents Act 2008

REGISTRATION TO VIEW RENTAL ACCOMODATION

1. Property Details
PROPERTY OF INTEREST 4 Hughes Avenue, Hokowhitu
DATE PROPERTY IS REQUIRED
18/12/2015
HOW LONG IS IT REQUIRED? More than 1 year
WHAT ARE THE THREE MOST IMPORTANT THINGS YOU ARE LOOKING FOR IN RENTAL ACCOMODATION?
1.Good Heating
2.Clean
3.Insulation
2. Personal Details
TITLE: (Circle)
Mr/Mrs/Miss/Ms
FIRST NAMES
Huda
CURRENT ADDRESS 34 Pahiatua Street
SUBURB
Hokowhitu
REASON FOR LEAVING Current house is cold and damp
PHONE A/H:
06 353 8820
OCCUPATION
PHD student
EMAIL ADDRESS: hudaalkaff@hotmail.com
CAR REGISTRATION: EHR15

D.O.B.
07 / 09 / 1969
LAST NAME: Alkaff
TIME AT THIS ADDRESS? 4 years 2011-2015
CITY Palmerston North
MOBILE 0211030176
EMPLOYER

WORK

3. Spouses Details
TITLE (Circle)
Mr/Mrs/Miss/Ms
FIRST NAMES
CURRENT ADDRESS
SUBURB
REASON FOR LEAVING
PHONE A/H
OCCUPATION
EMAIL ADDRESS:
CAR REGISTRATION:
SMOKERS/NON SMOKERS (Circle)
NO. PERSONS TO RESIDE AT PROPERTY
PLEASE SPECIFY AGES OF ANY CHILDREN

D.O.B.

LAST NAME
TIME AT THIS ADDRESS?
CITY
MOBILE
EMPLOYER

WORK

4. Other Details
DETAILS OF PETS none
4
ADULTS 1
15, 8, 5 years

CHILDREN 3

5. Other Intended Occupants

TITLE (Circle)
Mr/Mrs/Miss/Ms
FIRST NAMES
CURRENT ADDRESS
SUBURB
REASON FOR LEAVING
PHONE A/H
OCCUPATION
CAR REGISTRATION:
TITLE (Circle)
Mr/Mrs/Miss/Ms
FIRST NAMES
CURRENT ADDRESS
SUBURB
REASON FOR LEAVING
PHONE A/H
OCCUPATION
CAR REGISTRATION:

D.O.B.

LAST NAME
TIME AT THIS ADDRESS?
CITY
MOBILE
EMPLOYER

WORK

D.O.B.
LAST NAME
TIME AT THIS ADDRESS?
CITY
MOBILE
EMPLOYER

WORK

6. Identification
I.D. PROVIDED
(all
parties)(Circle)
I authorise
any person or
company
to provide you with such informationYES/NO
as you may require to your credit and/or employment enquiries. I further authorize you to furnish
to any third party details of this application and any subsequent dealings that I may have with you as a result of this registration being actioned by you. I agree to pay your fee
of 1 weeksPLEASE
rent + GSTNOTE:
on signingPhoto
the Tenancy
Agreement.
ID must
be provided before an appointment to view rental accommodation can be made.
I CONFIRM THAT THE FOREGOING IS CORRECT: H.A..
(Signed by all parties)
DATE: 7/12/2015.

WHAT WAS THE MAIN WAY YOU WERE MADE AWARE OF THIS PROPERTY?
Newspaper
Rental List
Trade Me
LJ Hooker.com
RealEstate.co.nz
Other (please specify)