Pre-Tenancy Application Form

Tenancy Details

Address of Property applying for:

Weekly Rent in $:

Required Commencement Date:

Type of Tenancy:
PeriodicFixed Term

Length of Tenancy:
6 months12 monthsother

Number of people to occupy the Property?



Age(s) Children:

Are any potential occupants smokers?

Name(s) of people applying for the property with you:

Please Note: all occupants over the age of 18 years are required to complete an application form

Applicant Details

Full Name:

Date of Birth:

Have you been known by any other name?

If yes, what other name are you known by:

Daytime contact number:

Mobile contact number:

Email Address:

Current Address:

How long have you lived there?

Please state why you are leaving this address:


Please provide photo identification, such as Drivers Licence or Passport:

Licence No:

Version No.(5b):

Car/vehicle registration number:

Make and model:

Passport No.

Alternative form of ID:

NB: Provision of this number is voluntary and will only be used to verify your identity and for carrying out a credit check.

Next of Kin Contact Details

Full Name:

Relationship to you?

Home contact number:

Mobile contact number:

Email address:

Address for Service:

Tenancy History and References

Have you ever had any Tenancy Tribunal Orders against you?

If yes, please state details:

Are you currently:
RentingBoardingFlattingHome ownerother

Weekly rent paid currently in $:

Bond held in $:

We reserve the right not to accept Bond Transfers

Name of Landlord/Agent:

Landlord/Agent phone number:

Is your landlord/agent aware that you are looking for a rental property:

Can we make contact with your current Landlord/Agent for a Tenancy reference:

What was your prior address to you current address:

How long have you lived there?

Were you previously:
RentingBoardingFlattingHome ownerOther

Name of Landlord/Agent:

Landlord/Agents phone number:

Weekly rent paid in $:

Was your Bond refunded in full?

If not please state why:

Employment/Income Details

Source of income:
Full-time employmentSelf-employmentContractWinzOther

What is your occupation?

Employers Name:

Employers address:

Contact person:

Contact number:

Length of employment:

Weekly/Monthly income in $:

Do you recieve a benefit?

Will your rent be paid directly from Winz?

What is your Winz number?


Do you have any Pets?

If yes what pets do you have?

List Type/Breed, Age, Sex, Registration No of your Pets:

Have you rented a property with your pet(s) before?

Do you have references for your pet(s)?

Have you had complaints in regards to your pets?

If yes, please give details?


Please provide two referees that can we can contact. Referees can be your employer or someone who knows you well (not a relative).

One of your referees should be able to provide a reference about your credit worthiness. If you have already provided your current landlord’s details, only one additional referee is needed.

Referee 1 Name:

Referee 1 contact number:

Referee 1 email address:

Referee 2 Name:

Referee 2 contact number:

Referee 2 email address:

I authorise the Landlord/Property Manager to:

  • collect, retain and use this information for the purpose of assessing my credit worthiness and suitability for the tenancy; and
  • disclose information about me, whether collected for me directly or from any other source, to any other credit provider and any credit agency for the purposes of providing or obtaining a credit report(which will involve the
    credit reporting agency providing information about me to the Landlord/Property Manager). This information may be relayed to the Owner of the property in the tenancy decision making process.

I understand that the credit reporting agency;

  • may hold my information on their credit reporting database and use it for providing credit reporting services, and
    they may disclose my information to their subscribers for the purpose of credit checking or debt collection; and
  • As part of providing a credit report, may check the Ministry of Justice fines, Tenancy Tribunal database and TINZ
    for any overdue fines or orders I may have.
Full Name:



Under the Privacy Act 19193, you have the right to ask for a copy of all information held about you, and have the right to request the correction of any incorrect information.

Completion of Application

To enable us to process your application for a tenancy you must;

  • have completed this application in full
  • have signed the above consent
  • provided proof of ID - Photo

Failure on any of the above will make this application invalid and will be automatically rejected for consideration.


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