Additional Applicant Details Sheet (29.03.21)

BLACK = Old Item/Clause | RED = New Item/Clause | BLUE = Comments About Change (Not Part of Form) | STRIKEOUT = Wording Deleted

All instances of 'Landlord' changed to 'Rental Provider'.

Form Heading

Applicant Details Sheet

(to be completed by each adult Applicant and unaccompanied minors and attached to the Application to Rent)

Item 1 Note

APPLICANT’S DETAILS (if more than one, attach an Applicant Details Sheet for each additional Applicant)

	Name: ………………………………………………………………………………………………………… Phone (H): (…)………… Phone (W): (…)………… Mobile: ……………… Date of Birth: … / … / … Email: ………………………………………………………………… Vehicle Rego No.: ……………….
1.1	Current Address: ………………………………………………………………………………………….. Period of Occupancy: …………. Situation: Renting/Owned/Other Other Situation: ……………… Rental Provider/Agent Details (if applicable): Name: ………………………… Phone: (…)…………… Email: ………………………………………………………………………… Phone: (…)………………… Rent: ………… Payment Period: Weekly/Fortnightly/Monthly Reason for Leaving: ………………
1.2	Previous Address (if applicable): ……………………………………………………………………….. Period of Occupancy: …………… Situation: Renting/Owned/Other Other Situation: …………… Rental Provider/Agent Details (if applicable): Name: ………………………… Phone: (…)…………… Email: ………………………………………………………………………… Phone: (…)………………… Rent: ………… Payment Period: Weekly/Fortnightly/Monthly Reason for Leaving: ………………
1.3	Have you ever been evicted from a premises? __ Yes __ No Are you currently in debt to any rental provider/agent? __ Yes __ No

Item 4

EMERGENCY CONTACT

Note: Required for matters of urgency where normal contact methods have failed. Required to contact you as a matter of urgency and your normal contact details are not responding.

Next of kin Name: …………….……………………………………………… Phone: (…)…..…………………

Address: …………….……………………………………………... Mobile: .….…..…………………

Other: …………….………………………………………………………… Phone: (…)…..……………………

Address: …………….………………………………………………………… Mobile: .….…..……………………

Item 5

100 POINTS OF IDENTIFICATION CHECKLIST Each Applicant must produce 100 points of I.D as marked with an asterisks (*).

...... Last 4 Rent Receipts 20 POINTS __	...... Phone, Electricity, Gas or rates Bills 15 POINTS (each) __
...... Driver's Licence 30 POINTS __	...... Pay slips …………………………… 15 POINTS __
...... Photo ID 30 POINTS __	...... Tenancy History Ledger 20 POINTS __
...... Passport 30 POINTS __	...... Bank/Cr Card statements 15 POINTS (each) __
...... Birth Certificate 30 POINTS __	...... ………………………………… ... POINTS __
...... Pension or Health Care 15 POINTS __	TOTAL POINTS: …………………………

__	I, the Applicant, give my consent for the Agent to make enquiries (in accordance with the Privacy Statement on the Application for Tenancy Form) to verify the information I have provided herein.
__	I, the Applicant, have read and agree to the information provided in the Application for Tenancy Form & agree to be bound by the Terms of Application detailed in the Application for Tenancy Form.

Item 5

SIGNATURE

By signing below the Applicant confirms:

(1)	the Applicant consents to the Rental Provider’s Agent making enquiries (in accordance with the Privacy Statement on the Application to Rent) to verify the information provided herein.
(2)	the Applicant has read the Application to Rent to which this Applicant Details Sheet is attached and agrees to be bound by the terms of such Application.
(3)	the Applicant has completed and attached the 100 Points of Identification Checklist.

Applicant’s Signature: Date: Rental Provider Landlord’s/Agent’s Signature: Date:

…………………………... …… / …… / …… ………………………………………… …… / …… / ……

Additional Applicant Details Sheet - AUVICREPM026