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Application for Residential Tenancy

Please Enter The Property Details
Address :
Date you would like to move in :

Please Enter Your Personal Details
Surname :
Firstname :
Middle Name :
Date of Birth :
Passport / Driver License :
Country of Origin :
Present Address :
Length of time at this address :
(If less than 2 years please give previous address) :
Phone Number :
Mobile Number :
Best Time to Contact :
Email :
Are you a smoker ?
Pet :
If yes please specify :
Car Registration :

Work Details in New Zealand
Name of Employer :
Address :
Period of Employment :
Occupation :
Can we contact your employer for a reference ?
(If yes please provide details of person to contact) :

Students Please State Where & Subject You are Studying
Name of Learning Institute :
Subject Being Studied :
Length of Course :
Time Left to End of Course :
Contact at Institution :

Other Occupants - Who Else Will be Living With You
Occupant 1 - Full Name :
Age :
Occupation :
Occupant 2 - Full Name :
Age :
Occupation :
Occupant 3 - Full Name :
Age :
Occupation :
Occupant 4 - Full Name :
Age :
Occupation :

Next of Kin Living in New Zealand (This Must be Completed For Use In Case of Emergency)
Name :
Phone :
Address :
Relationship to You :

Close Friend or Referee
Name :
Phone :
Address :
Relationship to You :

Rental History
Have You Rented Previously in New Zealand ?
Do You Have References ?
Address :
Length :
Landlord's Name :
Phone :
Address :

Confirm Application
I / We hereby authorize any authorized person of Ray White Bucklands Beach to obtain a tenants check in the course of any investigations that may be required regarding this tenancy.