904/265 Castlereagh Street, Sydney,NSW 2000 (PO BOX 20411, World Square 2002 SYDNEY NSW 2000) Ph: +61 2 8068 8806   
Email: asstpm@rnjrealty.com.au
Residential Tenancy Application Form  	All sections of this form must be completed & signed for your application to be processed

Proposed Rental Property address: 	Postcode 	

Rent Per Week: $

Bond Amount: $

Have you inspected the property?:   YES / NO (please circle)

Length of tenancy:	Years	Months

How many tenants will occupy the property?	Adults

Tenancy To Commence

Children	Ages

Pets: Yes / No (Circle)  Types:

Reg? Yes /No

Breed/s:

Vehicle 1 Rego:	Model/Year/Colour	Vehicle 2 Rego:	Model/Year /Colour

1. First Applicant 	

Title	First Name	Initial

1. Second Applicant AND/OR Partner 	

Title	First Name	Initial

Last Name

Other names: (Maiden, married etc)

Smoker	Yes / No

Last Name

Other names: (Maiden, married etc)

Smoker	Yes / No

Date of Birth	/	/	Age (Years / Months)

Date of Birth	/	/	Age (Years / Months)

Drivers Licence No.	State

NSW Card no.

Drivers Licence No.	State

NSW Card no.

Passport

Medicare No.	Ref:

Passport

Medicare No.	Ref:

Pension Type (if applicable)	No

Pension Type (if applicable)	No

Home Ph	Mobile Ph

Home Ph	Mobile Ph

Email

Email

Occupation	Work No

Marital status: Single   Married   De Facto  Sep/Div  Friends  Relatives

2. Rental History - Applicant 1 	

Current Address

Occupation	Work No

Marital status: Single   Married   De Facto  Sep/Div  Friends  Relatives

2. Rental History - Applicant 2 	

Current Address

Suburb	Postcode

Suburb	Postcode

How Long at Current Address?  	Years  	Months 	 Reason for Leaving:		Rent per week: $
Landlord/ Agent Name:	Agent Ph:

Previous Address

How Long at Current Address?  	Years  	Months 	 Reason for Leaving:		Rent per week: $
Landlord/ Agent Name:	Agent Ph:

Previous Address

Suburb	Postcode

Suburb	Postcode

Length at previous Address?

Years	Months

Length at previous Address?

Years	Months

Reason for Leaving:  	Rent per week: $ 	 Landlord/ Agent Name: 	Agent Ph: 	
Bond Refunded Yes / No	If not why?

Reason for Leaving:  	Rent per week: $ 	 Landlord/ Agent Name: 	 Agent Ph: 	
Bond Refunded Yes / No	If not why?

 3. Employment Details - Applicant 1 		 3. Employment Details - Applicant 2 	

Occupation	Employers Name

Employment Address

Suburb	Postcode

Occupation	Employers Name

Employment Address

Suburb	Postcode

Employer Phone No	Contact Name

Length at current employment	Years	Months

Net Income  $	Per Week $	Per Month $

Employer Phone No	Contact Name

Length at current employment	Years	Months

Net Income  $	Per Week $	Per Month $

Are you self employed? Yes / No	ABN:

Accountant Name:  	phone: 	

4.   Social Security Benefits OR Centrelink Payment 	

Type	CRN:

Are you self employed? Yes / No	ABN:

Accountant Name:  	phone: 	
4.   Social Security Benefits OR Centrelink Payment 	

Type	CRN:

$	Per Week	$	Per Month

$	Per Week	$	Per Month

5.  Referees - Applicant 1 - (NOT co-applicant) 	

1. Reference name

Address:

Home Phone	Mobile No

5.  Referees - Applicant 2 - (NOT co-applicant) 	

1. Reference name

Address:

Home Phone	Mobile No

2. Reference name

Address:

Home Phone	Mobile No

 6. Emergency Contact Details  - Not same as co-applicant
 Name 	Phone No 	

Address

2. Reference name

Address:

Home Phone	Mobile No
 6. Emergency Contact Details  - Not same as co-applicant
Name  	Phone  No

Address

Suburb	Postcode

Suburb	Postcode

  7. The Following Documents Should Be Enclosed with your Application - Bring originals for verification 	
ALL DOCUMENTS ARE TO BE COPIED AND ATTACHED TO YOUR APPLICATION  BEFORE SUBMITTING  IT.
Copy of Drivers Licence	Copy of Passport	Copy of Pay Slips	Copy of Medicare

Copy of Bank Statement	Copy of Tenant Ledger	References

 8. FREE Utillities Connections User Consent Form 	

Ph: 1300 680 603

•Electrical
•Gas

• Telephone
•Insurance

•Water
•Removalist

• Cleaners
• Appliances

ReduceMyBills is the hassle-free connections service  that  takes the time  and worry out  of moving.

Declaration
By signing this application, I/we give consent to ReduceMyBills to make contact by  phone, email or sms for  the purpose of arranging connections and disconnections of approved utility services. I/we authorise ReduceMyBills to supply collected information to other household service providers for  the services including Cleaning, Removal, Insurance and Appliances.
I/we authorise  ReduceMyBills to contact us  via these means even if the telephone numbers supplied are listed on the Do Not Call Register. I/we understand that ReduceMyBills may also send related  emails promoting other services provided by  ReduceMyBills.
I/we acknowledge that all information supplied in the application is true and correct to be best of  my/our knowledge and that we   have not falsely represented our identity in any manner.
I/we understand that ReduceMyBills treat any personal information it collects, uses or discloses in accordance with the Privacy Act 1988.

I/We authorise  ReduceMyBills to supply collected information to nominated suppliers and/or potential suppliers for  the connection and disconnection of nominated utilities or to assist with my  obtaining other services including appliances, removalists, cleaners and insurance.

I/we understand that in the course of connecting utilities, ReduceMyBills may need to obtain an NMI (National Meter Identifier) for  electrical  points  or MIRN (Meter Installation Registration Number) for  Natural Gas  connections. I/we authorise  ReduceMyBills to collect these  identifiers and consent to those numbers being supplied to utility providers.
I/We acknowledge that whilst ReduceMyBills is a free service, I/we are solely responsible for  any and all amounts payable in relation to deposits, connections/disconnections or ongoing supply of the connected services and amounts payable for  other services including appliance, removalist, cleaners and insurance.
I/we acknowledge that ReduceMyBills, to the extent permitted
by  law,  shall not be liable for  any loss or damage (including consequential loss and loss of profits) to me/us as a result of the provision of any service. Nor  shall ReduceMyBills be liable for  any act or omission by  any utility provider for  any loss caused by  failure to provide nominated services.
I/we acknowledge that the nominated real estate entity along with ReduceMyBills may receive a benefit from suppliers for  the provision of connections.
I/we declare that we have read  and understand the above declaration and wish  to be contacted by ReduceMyBills.

Signature	Date

  9. Declaration of Authority 	
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 such as NTD, TICA or
TRA for the purpose of checking your tenancy history;
I am aware that I may access my personal information by contacting -

•   NTD: 1300 563 826	•  TRA: (02) 9363 9244	• TICA: 1902 220 346

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 NTD (National Tenancies Database)

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.

Printed Name Applicant 1:	

Signature Applicant 1		Date	

Printed Name Applicant 2:	

Signature Applicant 2		Date	

10.  Payment Details 	

Property Rental Per Week

Rent in Advance	$ Rental Bond (4 weeks rent)	 $
Total Due	$	EFT/Bank Cheque/Money Order