Application for Residential Tenancy (One application to be completed per person) Part 1 Rental Property Details Item 1: Agent Details Agency name: Chateaux Property Management : Suite 1/6 Elliott Street, Bundall Qld 4217 (PO Box 7954, Gold Coast MC Qld 9726) : Mobile: 07 5504 5277 Email: admin@chateauxgroup.com.au Fax: 07 5526 8066 Item 2: Property Details Property address Rent $ a week a fortnight a month Bond $ Tenancy term Starting on / / Ending on / / Insert "fixed term agreement" or "periodic agreement". Part 2 Item 3: Applicant Details Contact Details Full name Have you been known by any other name(s)? If, what other name(s) have you been known by? Work phone Mobile Home phone Date of Birth Email: Driver's licence/passport number Number of vehicles Registration number(s) State Item 4: Dependants Do you have any dependants? Dependant full name(s) to Applicant Dependant Date of Birth Item 5: Item 6: Smoking Are you or any of the dependants living with you a smoker? Pets Do you intend to keep pets at the property? Number of pets Type of pet/s Are your pets registered with a council? If, please state which council: EF015 T15.8 08/09 Copyright REIQ Printed by REALW ORKS Live Page 1 of 4
Item 7: Applicants History Current residential address Period of occupancy Type of occupancy: Rent Owner Other > Current Agent/Lessor (if renting) Agent/Lessor phone Current rent $ a week a fortnight a month Reason for leaving: Previous residential address Period of occupancy Type of occupancy: Rent Owner Other > Previous Agent/Lessor Agent/Lessor phone Current rent $ a week a fortnight a month Reason for leaving: Item 8: Employment Details Are you employed? (if no, please provide details of previous employer, if any) Employment status: Full Time Part Time Casual Contract Self employed Occupation Date commenced employment (approx) Net income (per week) $ Date terminated employment (if any) Employer/Business Name If self employed, Accountant's Name Item 9: Centrelink Payments Are you receiving any regular Centrelink payments? Description of payment(s) Total income (per week) $ Date payments commenced Item 10: Student Details Are you studying full time? Name of education institution you are currently attending Student Identification Number Are you an overseas student? If yes, Visa expiry date: Page 2 of 4
Item 11: Personal References Please do not list relatives, another applicant or partners and provide business hours contact numbers. Referee 1 /Mobile Referee 2 /Mobile Item 12: Personal Representative i.e. preferred person(s) to be contacted in the event of an emergency. Representative 1 Representative 2 Part 3 Item 13: Supporting Documents Identification You are required to meet a 100 point identification criterion upon submission of your application. The agent/lessor may photocopy any item and retain as part of your application. Please tick the identifying documents you have provided with your application. IMPORTANT: At least one form of Photo Identification MUST be provided. 70 Points Passport 40 Points Australian driver's licence Centrelink Card 25 Points Medicare card Telephone bill Tenancy History Ledger Last FOUR rent receipts Full birth certificate Student Photo ID Proof of age card Council rates notice Electricity bill Bank statement Rent bond receipt Citizenship certificate Department of Veterans Affairs card State/Federal Government Photo ID Motor vehicle registration Gas bill Credit card statement Previous tenancy agreement Item 14: Proof of Income You are also required to supply the agent/lessor with proof of your income upon submission of your application. Employed: Self employed: t employed: Last TWO pay slips. Bank Statements, Group Certificate, Tax Return or Accountant's letter. Centrelink Statement. Page 3 of 4
Part 4 Declaration Please declare the following by selecting either TRUE or FALSE I, the Applicant, 1. have never been evicted by an agent/lessor 2. have no known reasons that would affect my ability to pay rent 3. was refunded the rental bond for my last address in full (if applicable) If false, please advise what deductions were made from your bond? 4. have no outstanding debt to another agent/lessor? If false, why are you in debt to your past agent/lessor? Part 5 Acknowledgement Please acknoweldge the following by selecting either or I, the Applicant, 1. acknowledge that my personal contents insurance is not covered under any lessor insurance policy/s and understand that it is my responsibility to insure my own personal belongings. 2. understand that you as the agent/lessor have collected this information for the purpose of determining whether I am a suitable tenant for the property - in particular to check my identification, my ability to care for the property, my character and my creditworthiness. 2.1 for such purposes, I authorise you to contact the persons named in this application, and to undertake such enquiries and searches (including tenancy databases searches) as you consider reasonably necessary. 2.2 in doing so, I understand that information provided by me may be disclosed to, and further information obtained from, referees named in this application and other relevant third parties. 3. acknowledge and accept that if this application is denied, the agent is not legally obliged to provide reasons as to why. 4. consent and understand that should my tenancy be accepted and upon commencement of the tenancy agreement, there may be cause for the agent/lessor to pass my details onto others which may include (but is not limited to) insurance companies, body corporates, contractors, other real estate agents, salespeople and tenancy default databases. 5. acknowledge that I have received and reviewed the General Tenancy Agreement (Form 18a), the standard terms and any special terms before completing this application. 6. acknowledge that I have received or have available the Information Statement (Form 17a), body corporate by-laws (if applicable) before completing this application. 7. acknowledge that I have been made aware of the agency's Privacy Policy. 8. acknowledge that the lessor and applicant (tenant) are bound by this agreement immediately upon communication of either the lessor or agent's acceptance of the application. 9. consent to the use of email and facsimile in accordance with the provisions set out in Chapter 2 of the Electronic Transactions (Queensland) Act 2001 (Qld) and the Electronic Transactions Act 1999 (Cth); 10. declare that the above information is true & correct and that I have supplied it of my own free will. Name of Applicant Signature Date Page 4 of 4
Your Free Obligation Connection Service Chateaux Property Management - Bundall : Suite 1 / 6 Elliott Street, Bundall QLD 4217 Postal: PO Box 7954, Gold Coast Mail Centre QLD 9726 : (07) 5504 5277 Fax: 07 5526 8066 E-mail: admin@chateauxgroup.com.au Website: www.chateaux.com.au Step 1 Select the utilities you would like connected by ticking the relevant boxes below. Please tick utilities as required Electricity Gas Step 2 Fill out the relevant details on this form, sign it and lodge it with your property manager. Pay TV Step 3 We will call you within 24 hours (except on weekends and public holidays), to confirm your details and connection timings. Insurance Internet Removalist Name of Applicant For Connection Postcode Contact Number Date Of Birth CONNECTION DATE 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 tice 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 tice 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 tice 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 t 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: P: 1300 664 715 F: 1300 664 185 W: www.agents.directconnect.com.au Level 9 Toowong Tower, 9 Sherwood Rd, Toowong QLD 4066