Haughton Stotts Real Estate Tenancy Application

In order to apply for a property please complete all required information in the application form.

Downloadable Tenant Application Form [ Tenants Application Form ]
(Right mouse click and "Save Target As" to save a copy to your hard disk.)

Please download this form, complete and then fax it to Haughton Stotts Real Estate
F (03) 9497 4374 with copies of your identification.

Note: Applications will only be processed after confirmation of inspection of the property.

Required Identification

All applicants will be required to provide 100 points of identification as that need to accompany this application as listed below:

Drivers Licence	50 points
Passport	50 points
Birth Certificate	50 points
Proof of Age Card	50 points
Rates Notice	20 points
Student ID	20 points
Current Wage Advice	20 points
Previous 2 Rent Receipts	20 points
Gas or Electricity Account	20 points
Bank Statement	10 points
Concession or Pension Card	10 points
Photocopy of photo ID is required

Declaration

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 about me from:

(a) The owner or the Agent of my current or previous residences;
(b) My personal referees for this application
(c) My current and past employers;
(d) Any person who maintains any record, listing or database of defaults by tenants; and I authorise and consent to each of those persons providing requested personal information about me to the Agent.

If I default under a rental agreement, I agree that the Agent may disclose details of any such default to a tenancy database and to agents/landlords of properties I may apply for in 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 trades people 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)
(h) transfer water account details into my name 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. I am aware that I may access personal information on the contact details above.

Utility Connection

CONNECTING YOUR UTILITIES HAS NEVER BEEN EASIER

If you would like assistance (at no additional charge) with the connection of telephone, electricity and gas to your new home then tick the "Arrange Utilities connection" box in the application form.

My connect will then contact you and explain the details of the services available. Myconnect will use the information on this page to explain the services offered and to undertake any connection and disconnection services authorized (including the provision of information to utility companies).

All details on this page must be completed for the service to be provided. Personal information collected by Myconnect may be accessed by contacting Myconnect using the contact details above. Normal service provider fees or bonds may apply.

Utility connection services are provided by: MyConnect

Phone : 1300 854 478
Fax : 1300 854 479
Email : enquiry@myconnect.com.au
Web Site : www.myconnect.com.au

By ticking yes to the "Arrange Utilities connection" question, I consent and acknowledge the following:

consent to the disclosure of information on this form to myconnect ABN 34121 892 331 for the purpose of arranging the connection of nominated utility services;
consent to myconnect disclosing personal information to utility service providers for the stated purpose and obtaining confirmation of connection;
consent to myconnect disclosing confirmation details (including NMI, MIRN, utility provider) to the Real Estate Agent; acknowledge the Real Estate Agent, its employees and myconnect may receive a fee/incentive from a utility provider in relation to the connection of utility services;
acknowledge that whilst myconnect is a free service, a standard connection fee and/or deposit may be required by various utility providers;
acknowledge that, to the extent permitted by law, the Real Estate Agent, its employees and myconnect 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 services or any act or omission by the utility provider or for any loss caused by or in connection with any delay in connection or provision of, or failure to connect or provide the nominated utilities.
I/ We acknowledge that neither Myconnect nor the Agent accepts any responsibility for any delays, or failure to arrange or provide for, any connection or disconnection of a utility, or for any loss in connection with such delay or failure.
I/ We acknowledge that the Agent, its employees and Myconnect may receive a fee/benefit from a free service provider in relation to the connection of a utility service.
There is no charge for the Myconnect service; normal service provider fees or bonds may apply.