Email : derbywest@belvoir.co.

uk
Telephone : 01773 535353

TENANT APPLICATION FORM

This form must be completed by each intended occupier over 18 years of age

ADDRESS OF PROPERTY BEING APPLIED FOR : 2 bed flat. Grower street . RENT PCM: 600 SHARE OF RENT: 50%
Rm 703

(MR/MRS/MS) FULL NAME: Mrs. Yetunde Taiwo NI NO: NJ719715D

DATE OF BIRTH: 05/08/1987

MOBILE NO: 07459848898 EMAIL ADDRESS: yetundetaiwo07@gmail.com

HOME TEL

CURRENT ADDRESS: 156B Chaddesden Park Road, Derby

POST CODE: DE21 6HJ

RESIDENTIAL STATUS: WITH FAMILY

IF YOU ARE NOT A UK RESIDENT YOU MUST PROVIDE US WITH YOUR GOVERNMENT RIGHT TO RENT SHARE CODE:

RSCH67ZTJ…………………………………………………………..

HOW LONG HAVE YOU LIVED THERE: 1 month. REASON FOR LEAVING: It’s a family member’s residence, now we need to
get our apartment because my partner just got into the country 1st May, 2022

WHO IS YOUR LANDLORD: AGENCY / PRIVATE

DETAILS OF EMPLOYERS: …………………………………………………………………………………………………………

GROSS SALARY PER YEAR (Not including overtime/commission): £ …………………………………………

DO YOU HAVE A PERMANENT CONTRACT: NO But we both have rights to work and would soon be in employment

If no details of employment: We are just settling in but we saved enough to rent for 6 months while we get a job. We also
have a guarantor who is a medical doctor and earns 50,000 whose contact can be provided if requested.

Do you smoke? NO

Do you have any pets: /NO if yes details of pets …………………………………………………………………………………………………………..

Do you have children: YES If yes please give ages. 3 years and 6 years

Do you have a criminal record: NO: If yes please give details………………………………………………………………………………………

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Have you ever had any CCJ’s / IVA’s (satisfied or not) NO . If yes please give details…………………………………………………………

……………………………………………………………………………………………………………………………………………………………………………………………..

It is important that you check your credit history if you are unsure whether or not you have unsatisfied CCJ’s as this would
result in you loosing your holding deposit if you are found to have any when being referenced.

……………………………………………………………………………………………………………………………………………………………………………………………..

Do you currently have any rent arrears : NO Have you always paid your rent on time: YES

Have you ever had money deducted from your deposit when previously renting :NO ………………………………………………
 Will you be paying the first months rent and the deposit for the property should your application be successful ?

YES. if NO please state who will be responsible for the payment of the funds………………………………………………………

Do you consent Belvoir Elder & Twells/Belvoir Burton to pass your details to 3 rd parties ie utility companies, broadband
providers YES

Additional Documents Required.

Please supply the following documents to support your application:

Photographic ID – passport
2 Proof of your current address dated in the last 3 months. This could be Utility
Bill, Bank Statement, payslip or council tax statement

Terms and Conditions

All information provided to us is correct including all credit history.
Applications can be submitted once a property viewing has taken place.
Applications submitted to us will be forwarded to the landlord for appraisal. It will be the decision of the landlord
which application they will proceed with.
Should the landlord wish to proceed with your application, a holding deposit of 1 week’s rent will be requested.
Should your application be successful, and all referencing is satisfactory, collection of the property keys will be at our
office located at 15 MARKET STREET HEANOR, DERBYSHIRE, DE75 7NR.
The accounts department will request the balance of monies which must be paid and funds cleared 3 days before the
start of the tenancy.
Collection of keys will be on FRIDAY ONLY and during office hours 10am to 5pm. All tenants must be present to sign
and receive all tenancy documents.
Belvoir Derby West, Belvoir Elder & Twells and Belvoir Burton is committed to protecting and processing your personal
data in accordance with the General Data Protection Regulations and the Data Protection Act 2018 (the legislation).
Our Privacy statements can be viewed online at https://www.belvoir.co.uk/derby-west-estate-agents/privacy-policy/
or https://www.belvoir.co.uk/burton-upon-trent-estate-agents/privacy-policy/

Declaration: I declare that the information I have provided on this form is true and correct and hereby authorise you to
verify the details given and to seek references as required, including a bankers reference and a credit check.

I agree to you disclosing the reference replies to the landlord/s of the property for which I am applying.

I understand this does not represent any offer or contract of any nature. I also understand that if you decline to offer me
a tenancy no explanation need be given.

I have read and understand the Terms and Conditions as described above

Signed by applicant: ………………………………………………………………………………………………..

Print name: ………………………………………………………………………

Signed by applicant: ………………………………………………………………………………………………..

Print name: ………………………………………………………………………

Date: ……………………………………………….