Tenancy Application Form

Please be advised, this application will only be processed once ALL details have been completed and all copies of all supporting documents attached. Each applicant must submit an individual form.

A. AGENCY DETAILS

Australian Mobile Property Managers

PO Box 2817
Southport BC
Queensland 4215
Phone: 1300 76 83 10
Fax: 07 5636 0270
Web: www.ampmrentals.com.au

*Property Manager

B. PROPERTY DETAILS

*Address of Property:

*Lease Commencement Date:

Day Month Year

*Lease Term:

Years Months

*How many tenants will occupy the property?:

Adults Children Ages of Children

C. PERSONAL DETAILS

5. *Please give us your details

Mr

Ms

Miss

Mrs

Dr

Other

*Surname

*Given Names/s

*Date Of Birth

*Driver's licence number

*Driver's licence expiry date

*Driver's licence state

*Passport no.

*Passport country

Pension no. (if applicable)

Pension type (if applicable)

6. *Please provide your contact details

*Home phone no

*Mobile phone no.

*Work phone no.

*Fax no.

*Email address

7. *What is your current address?

8. *How did you find out about this property?

Newspaper

The Internet

Local Paper

Office

Office Window

Sign Board at property

Referral

Other (specify)

D. UTILITY CONNECTIONS

This is a free service that connects all your utilities Once we have received this application we will call you to confirm your details.

Direct Connect will make all reasonable efforts to contact you within 24 hours of the nearest working day on receipt of this Application to confirm the information on this Application and explain the details of the services offered. Direct Connect is a utility one stop connection service.

*Please tick utilities as required

Electricity

Phone

Internet

Removals

Gas

Pay TV

Insurance

DECLARATION AND EXECUTION: By signing this application, I/we: consent to Direct Connect arranging for the connection and disconnection of the nominated utility services and to providing information contained in this application to utility providers for this purpose; acknowledge having been provided with terms and Conditions of Supply of Direct Connect and having read and understood them together with the Privacy Collection Notice set out below; declare that all the information contained in this application is true and correct and given of their own free will; expressly authorise Direct Connect to provide any information disclosed in this Application to a supplier or potential supplier of the Services in accordance with the Privacy Collection Notice and to obtain any information necessary in relation to the Services; expressly authorise Direct Connect to provide any information disclosed in this Application to an information provider for the purpose of that information provider disclosing it to a supplier or potential supplier of the Services in accordance with the Privacy Collection Notice and to obtain any information necessary in relation to the Services; consent to Direct Connect contacting me by telephone or by SMS in relation to the marketing or promotion of all of the services listed under the heading "Utility Connections" above even if we/I have not applied for the connection of those services in this application. This consent will continue [for a period of 1 year from the date of our/my execution of this application/until [28] days after we/I disconnect the last of the services in respect of which this application is made]; acknowledge that this consent will permit Direct Connect to contact us/me even if the telephone numbers listed on this application form are listed on the Do Not Call Register; understand that under the requirements of the Privacy Act 1988, Direct Connect will ensure that all personal information obtained about me/us will be appropriately collected, used, disclosed and transferred and will be stored safely and protected against loss, unauthorised access, use, modification or disclosure and any other misuse; authorise the obtaining of a National Metering Identifier (NMI) for my residential address to obtain supply details; consent to Direct Connect disclosing my/our details to utility providers (including my/our NMI and telephone number); declare and undertake to be solely responsible for all amounts payable in relation to the connections and/or supply of the Services and hereby indemnify Direct Connect and its officers, servants and agents and hold them indemnified against any charges whatsoever in respect of the Services; acknowledge that, to the extent permitted by law, Direct Connect shall not be liable for any loss or damage (including consequential loss and loss of profits) to me/us or any other person or any property as a result of the provision of the services or any act or omission by the utility provider or for any loss caused by or in connection with any delay in connection, disconnection or provision of, or failure to connect or disconnect or provide, the nominated utilities; acknowledge that whilst Direct Connect is a free service I/we may be required to pay standard connection fees or deposits required by various utility providers; acknowledge that the Services will be provided according to the applicable regulations and that the time frames and terms and conditions of the nominated utility providers bind me/us and that after hours connections may incur additional service fees from utility providers; acknowledge that the real estate agent listed on this application form may receive a benefit from Direct Connect in connection with the provision of the service being provided to me/us by Direct Connect; and acknowledge the entitlement of Direct Connect and its associates, agents and contractors, to receive a fee or remuneration from the utility provider and that such fee or remuneration will not be refunded to me as a rebate in connection with the provision of the utility connection services.By signing this application form, I warrant that I am authorised to make this application and to provide the consents, acknowledgements, authorisations and other undertakings set out in this application form on behalf of all applicants listed in this application form.

*Signature

*Date

PO Box 1519, Box Hill, Victoria 3128. P: 1300 664 715 F:1300 664 185. www.directconnect.com.au

E. DECLARATION

I hereby offer to rent the property from the owner under a lease to be prepared by the Agent. Should this application be accepted by the landlord I agree to enter Into a Residential Tenancy Agreement.

I acknowledge that this application is subject to the approval of the owner/landlord. I declare that all information contained in this application (including the reverse side) is true and correct and given of my own free will. I declare that I have Inspected the premises and am not bankrupt.

I authorise the Agent to obtain personal Information from: (a) The owner or the Agent of my current or previous residence; (b) My personal referees and employer/s; (c) Any record listing or database of defaults by tenants; If I default under a rental agreement, I agree that the Agent may disclose details of any such default to a tenancy default database, and to agents/landlords of properties I may apply for in the future.

I am aware that the Agent will use and disclose my personal information in order to: (a) communicate with the owner and select a tenant (b) prepare lease/tenancy documents (c) allow tradespeople or equivalent organisations to contact me (d) lodge/claim/transfer to/from a Bond Authority (e) refer to Tribunals/Courts & Statutory Authorities (where applicable) (f) refer to collection agents/lawyers (where applicable) (g) complete a credit check with TICA (Tenancy Information Centre Australia)

I am aware that if information is not provided or I do not consent to the uses to which personal information is put. the Agent cannot provide me with the lease/tenancy of the premises. I am aware that I may access personal information on the contact details above.

*Signature

*Date

OFFICE USE ONLY

Application submitted to Direct Connect (If Required)

F. APPLICANT HISTORY

9.* How long have you lived at your current address?

Years Months

10. *Why are you leaving this address?

11. Landlord/Agent details of this property (if applicable) Name of landlord or agent

*Landlord/agent's phone/fax no.

*Weekly Rent Paid.

$

12. *What was your previous residential address?

13. *How long did you live at this address?

Years Months

14. Landlord/Agent details of this property (if applicable) Name of landlord or agent

*Landlord/agent's phone/fax no.

*Weekly Rent Paid.

$

*Was bond refunded in full?

*If not why not?

G. EMPLOYMENT HISTORY

15. *Please provide your employment details
What is your occupation?

*What is the nature of your employment? (circle)

Full Time

Part Time

Casual

*Employer's name (accountant if self employed or institution if student)

*Employer's address (accountant if self employed or institution if student))

*Contact name

*Phone no

*Length of employment

Years Months

*Net Income

$

16. *Please provide your previous employment details
Occupation?

*Employer's name

*Length of employment

Years Months

*Net Income

$

H. CONTACTS/REFERENCES

17. Please provide a contact in case of emergency

*Surname

*Given Names/s

*Relationship to you

*Phone no.

18. *Please provide 2 personal references (not related to you)

1. *Surname

*Given name/s

*Relationship to you

*Phone no.

2. *Surname

*Given name/s

*Relationship to you

*Phone no.

I. OTHER INFORMATION

19. *Car Registration

20. Please provide details of any pets

*Breed/type

*Council registration / number

J. PAYMENT DETAILS

*Property Rental

$ per week OR $ per month

*Rental Bond (4 weeks rent):

$

*Rental Bond (4 weeks rent):

$

*Sub Total

$

*Amount payable on signing tenancy agreement (bank cheque or money order only)

$

K. 100 Points of ID Required

We require 100 Points of ID.
You must have:
1. A current drivers Licence or other photo ID
2. Current proof of income
3. Current rent ledger (if renting)
Application without 100 Points of ID will not be accepted.
Your 100 Point Check

Drivers Licence 40 Points
Passport 40 Points
Birth Certificate/Extract 30 Points
Other PhotoID 30 Points
Current proof of income 20 Points
Previous Landlord Reference 20 Points
Rent Ledger from other Agent 20 Points
Motor Vehicle Registration Certificate 10 Points
Bank Statement / Bank Card 10 Points
Phone / Electricity/ Gas Account 10 Points
Pension Card 20 Points
Medicare / Health Care Card 10 Points
Rates Notice (Proof of Ownership) 20 Points

*Signature

*Date

*Upload your 100 points of ID

 
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