Tenancy Agreement Form NZ

Harcourts Property Management
Residential Tenancy Application Form

Harcourts Kaikoura, 94 Beach Road, New Zealand
Office: 03 319 5800, Fax: 0064 (3) 319 5843, Email: enquiries.kaikoura@harcourts.co.nz, Website: www.harcourts.co.nz

How did you hear about this property?

1. PROPERTY DETAILS

Address of Property applying for:

Weekly Rent: $ Preferred Tenancy Commencement Date:

How many persons will occupy the Property? No. Adults: No. Children:

Age(s) of children: Are any of the intended occupants smokers? Yes No

Name(s) of persons applying for this property with you:

Please Note: All intended occupants over the age of 18 years must complete an individual application form

2. PERSONAL DETAILS

Full Name:

Have you been known by any other name? Yes No

If yes, what other name(s) have you been known by?

Date of Birth: Age:

Drivers licence number: Version number (5b):

Home Phone: Mobile:

Work Phone:

Email Address:

3. TENANCY HISTORY/REFERENCES

Have you ever had any Tenancy Tribunal Orders against you? Yes No Not sure

If yes, please state details:

Current Address:

How long have you lived at your current address? Months/Years

Are you currently: Renting Boarding Flatting Own your own home Other:

Why are you leaving this address?

Weekly rent paid: $ Bond held: $

Name of Landlord/Agent: Landlord/Agent phone number:

Is your landlord/agent aware that you are looking for a rental property? Yes No

Can we contact your current landlord/agent for a Tenancy reference? Yes No

What was your previous address?

How long have you lived at your previous address? Months/Years

Were you? Renting Boarding Flatting Owned your own home Other:

Name of Landlord/Agent? Landlord/Agents phone number:

Weekly rent paid: $ Was your bond refunded in full? Yes No

If not please state why:

4. EMPLOYMENT DETAILS

On what basis are you currently employed? Full time Part time Casual Contract Self Employed

What is your occupation?

Employers name:

Contact Person: Contact phone number:

Length of employment: Weekly/Monthly income: $

5. SELF EMPLOYED

How long have you been self-employed? Business Name:

Is your Company Registered? Yes No If yes, Registration Number:

Do you draw a salary / wage? Yes No If no, how do you intend to pay rent?

6. STUDENT DETAILS

What Institute do you attend?

Are you an overseas student? Yes No Visa Expiry Date:

Who is responsible for your rent payments? Myself Other

If other please give details:

7. WINZ

Do you receive a benefit? Yes No What type of benefit?

Will your rent be paid direct from WINZ? Yes No

If yes, please attach a copy of the application form for rent to be paid direct from WINZ – this needs to be signed by yourself and the landlord/agent

8. MOTOR VEHICLE DETAILS

How many vehicles will be kept at the property including your own?

Make/Model: Registration number:

Make/Model: Registration number:

9. PETS (please list details of all pets that will be kept at the property)

Do you have any pets? Yes No

Type & Breed: Age: Sex: Registration #

Type & Breed: Age: Sex: Registration #

Have you rented a property with your pet(s) before? Yes No Do you have any references for your pet(s)? Yes No

10. NEXT OF KIN CONTACT DETAILS (please provide a contact person not living with you, and living in NZ, in the event of an emergency)

Full name(s):

Relationship to you? Home phone number:

Mobile phone number: Email address:

Address:

11. ADDRESS FOR SERVICE DETAILS (this must be a NZ address. A workplace or family members address is ideal.)

Address for service: Email address:

Address for service

An address for service is a physical street address where documents relating to the tenancy will be accepted by you or on your behalf, even after the tenancy has ended. In addition to a physical address, a PO Box, fax number, or email address can also be provided. Tenants must record the address for service on the tenancy agreement and the Bond lodgement form. It is very important to tell us if this address changes.

12. ADDITIONAL TENANCY REFERENCES AND/OR PERSONAL REFEREES

1. Name: Relationship to you:

Phone: Email:

2. Name: Relationship to you:

Phone: Email:

13. PRIVACY DISCLOSURE STATEMENT

Harcourts Kaikoura is an independently owned and operated business. We are bound by the Privacy Act 1993. We collect information about you in this form to assess your application for a Residential Tenancy. We may need to collect information about you from your previous Landlord or Agent, your current Employer and your Referees. We will also check whether any details of Tenancy default by you are held on a Tenancy Default Database. Your consent to us collecting this information is set out below. We may disclose personal information about you to the Owner of the Property to which this application relates and any third party company as outlined below. If this application is successful we may disclose your details to service providers relevant to the tenancy relationships including maintenance contractors and Landlord’s insurers. We may also send personal information about you to the Owners of other Properties at your request. You have the right to access personal information that we hold about you by contacting our privacy officer. If you do not complete this form or do not sign the consent below then your application for a Residential Tenancy may not be considered by the relevant Property or, if considered, may be rejected.

14. PRIVACY CONSENT AND DECLARATION

I agree to the collection, use and disclosure of my personal information for the following purposes;

• Checking any of the details contained in this application form with third parties including any Tenant Information Database and the New Zealand Transport Authority.

• Making enquiries with third parties in relation to my creditworthiness, including any credit reporting agency.

• Placing any of the information regarding my identity supplied on this application form on a national online database.

• Using any of the information contained on any Tenancy Tribunal Order to assist the enforcement of any unsatisfied Money Order made against me by listing details of the order on an online national database.

• Using any of the information on this application form to assist in the enforcement of any unsatisfied Order made against me by the Tenancy Tribunal.

• Debt recovery purposes including appointing an agent to collect any outstanding debts and listing defaults with any credit reporting agency.

• Checking the Ministry of Justice fines database. This may be undertaken by a credit reporting agency on our behalf which will require my personal information to be collected by and disclosed to the credit reporting agency.

I understand that any credit reporting agency to whom you may disclose my personal information may:

• Hold that information on their credit reporting database;

• Use that information for the purpose of credit reporting or for any other lawful purpose;

• Disclose that information to their subscribers for the purpose of credit checking or debt collection of for any other lawful purpose.

I understand that if I have provided to you Driver Licence information that the provision of this information was voluntary.

I confirm the information in this form is true and correct and that I have read and signed the Cautions under the Privacy Act 1993.

I agree that if I enter a Tenancy Agreement then this application will form part of the Tenancy Agreement. Cautions provided pursuant to the Privacy Act 1993 and other information before applying for a Residential Tenancy

In Terms of the Privacy Act 1993 you are given notice that:

1) Requests Information – this application form asks you to provide personal information and

2) Purpose of Collection – the information collected on this form is required so that the Landlord is better able to assess whether you would be the best applicant on merit for the Tenancy and to record limited information contained in the application form on a web-based database. The limited information concerns your identity and your last known address. This information is required to assist the Landlord in locating you to enforce any unsatisfied money order made by the Tenancy Tribunal.

3) Recipient of Information – the information is provided by you to the Owner/Landlord/Agent/Property Manager.

4) Sight Information – I/we advise you that you have the right to see the information I/we hold about you.

5) Correct Information – to correct that information if it is incorrect in accordance with the Privacy Act 1993.

6) Holding Information – if you do not enter a Tenancy Agreement with the Landlord referred to on this application form, the application form will be destroyed.

7) Uses of Information – you are advised that some information relating to your identity and last known address may be supplied to a national web-based database.

8) Agree to pay letting fee on entering premises.

Other information drawn to your attention:

By completing this form you evidence the fact that you are applying to rent a Residential Property, and –

You are further advised that: If you do not supply all the information requested (other than the Driver Licence information) in this application form you may not be considered as the best applicant for the rental property or properties available.

Please Note: A separate completed application form is required for each person who proposes to enter a Tenancy Agreement.

I, (please state full legal name) do solemnly and sincerely declare that I am over 18 years of age and affirm the information given in this form to be true and correct.

15. SUPPORTING DOCUMENTATION

Please supply all supporting documentation to this application form, including:

A colour photocopy of your identification such as Drivers Licence or Passport

If you are not a New Zealand Citizen, a copy of your Visa (work/student)

Any Written References (personal / tenancy)

Your last 3 payslips or a current copy of your bank statement

PETS:

Any written references

A colour photograph of your pet(s)

You can email these supporting documents to enquiries.kaikoura@harcourts.co.nz