Applicant’s Consent

I hereby expressly consent to my personal details including any forwarding address at the termination of any tenancy being passed to the landlord and/or to the utility company and/or to the local authority.

This field is required.*

I understand that other than for reasons outlined above, all information will be treated as confidential.

Declaration

I am applying for tenancy on the basis that the property or accommodation will be my main and only home.

I give permission for enquiries to be made based on the information I have provided to establish my status.

I also certify that I do not

• Have any County Court Judgements against me
• Owe money to any Housing Benefit Department or any Local Authority
• Owe monies or dilapidation monies to any previous landlord
• Have substance or alcohol abuse problems

IF YOU KNOWINGLY SUPPLY FALSE INFORMATION IT MAY BE USED BY THE LANDLORD TO SEEK POSSESSION OF THE PROPERTY UNDER GROUND 17 OF SECTION 8 OF THE HOUSING ACT 1988 (AS AMENDED BY SECTION 102 OF THE HOUSING ACT 1996).

The information on this form is for the sole use of the landlord only for the purpose of letting. No information contained therein will be divulged to any third party, unless the Tenant defaults.

Application

First Name *

Last Name *

Email *

Property Applied For *

Date of Birth *

Place of Birth *

Telephone number *

If you have been known by any other name, please provide details and dates

Please supply your address(es) for the last 3 years starting with your current address.

Current Address *

Postcode *

Current Rent *

From *

To *

Landlords Name *

Landlords Tel. No *

Landlords Email

Previous Address One

Postcode

From

To

Landlords Name

Landlords Tel. No

Landlords Email

Do you have any children? If yes how many and please provide ages: *

Are you in rent arrears currently? * No Yes

If yes, please provide details

Do you have any criminal convictions? * No Yes

If yes, please provide details

Next of Kin Name *

Relationship to Applicant *

Next of Kin Contact Number *

Next of Kin Address *

Passport Number

Date of Issue

Place of Issue

Employment

Name of Employer or last employer *

Address of Employer or last employer *

Postcode

Your Job/Title or description *

Name of your work supervisor *

Telephone No *

Email *

Dates of Employment: From *

To

Present Salary *

Per Week/Month/Year * Per Week Per Month Per Year

Are your employment circumstances likely to change in the period of the tenancy/the next year? (whichever is shorter) No Yes

Are you claiming Local housing allowance? * No Yes

If yes, confirm LHA rate

Are you claiming Universal Credit? * No Yes

If yes, please provide details

Are you claiming Housing Benefit? * No Yes

If yes, confirm amount

Name of Local Authority

National Insurance No *

Do any of the current occupants smoke? *

Do you have any pets? * Yes No

If so, What?

Are you applying with anyone else over the age of 18? Yes No

If Yes, please give names of the other people applying

Relationship to you

(Please note, anyone else over the age of 18 will still need to complete an application form)

We treat your privacy seriously. We will never sell your information. We will never pass your information on to third parties without your consent, or use it for any reason other than those you allow.

I understand that other than for reasons outlined above, all information will be treated as confidential.

I confirm that I have inspected the property I am applying for and assessed its suitability in terms of condition, state of repair, cleanliness, size, location and it fulfils my needs. I have not identified any issues with the aforementioned worth noting

I confirm I have the right to remain in the UK

I agree to the terms above and that the information provided is genuine

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