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Tenancy Application Form
This information is required for the purposes of assessing your eligibility as a tenant.
One form should be completed for every intending adult tenant.
Tenancy Details
Applying Property address
Date you could start the tenancy / / Length of tenancy you would like
Do you have a legal right to remain in New Zealand for the duration of a tenancy Yes No
Applicant Details
First name Date of birth
Middle name Phone
Last name Smoker? Yes No
Email ID Supplied Driver Licence Other
Other ID no. Licence no. Version
Current Address and Landlord’s Details
If you are currently renting, please provide your landlord’s name and contact details.
Current address
How long at this address Reason for leaving
Landlord name
Landlord phone Landlord email
May I contact this person for a reference? Yes No
Personal References
We prefer at least 2 contacts. They cannot be family members or people you intend to live with.
**Please ensure you have the permission of any individual whose details you share with us.**
Referee name #1 Relationship
Email Phone
Referee name #2 Relationship
Email Phone
Referee name #3 Relationship
Email Phone
Employment
Your employer may be contacted
**Please ensure you have the permission of any individual whose details you share with us.**
What is your source of income Employment WINZ Benefit Study Link Self-employed
Employer company name
Job description
Contact person Contact Phone
Benefit type Customer number
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Tenant #2 Details
First name Date of birth
Middle name Phone
Last name Smoker? Yes No
Email ID Supplied Driver Licence Other
Other ID no. Licence no. Version
Tenant #2 Employment
Your employer may be contacted
**Please ensure you have the permission of any individual whose details you share with us.**
What is your source of income Employment WINZ Benefit Study Link Self-employed
Employer company name
Job description
Contact person Contact Phone
Benefit type Customer number
Tenant #2 Current Address and Landlord’s Details (If it is different)
If you are currently renting, please provide your landlord’s name and contact details.
Current address
How long at this
Reason for leaving
address
Landlord name
Landlord phone Landlord email
May I contact this person for a reference? Yes No
Rental Requirements
How many adults How many Children
Child name #1 DOB Relationship
Child name #2 DOB Relationship
Child name #3 DOB Relationship
Do you have pets? Yes No
How many pets Type of pets
Will you be parking a vehicle on the property? Yes No
Make Model Colour
Make Model Colour
History
Have you ever been to the Tenanct Tribunal? Yes No
If Yes please provide details:
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Have you ever been to the Tenanct Tribunal? Yes No
If Yes please provide details:
Do you owe money to your current landlord? Yes No
If Yes please provide details:
Emergency Contact / Authorised Third Party Contact
**Please ensure you have the permission of any individual whose details you share with us.**
Name
Phone Relationship
Privacy Statement
By completing this Tenancy Application Form, you agree to the collection, use and disclosure of Personal Information by
illion Tenancy and or your Landlord (together “We”) in accordance with this Privacy Statement. Personal Information
includes any information that identifies you or another person, that you provide, or have provided, to us or authorise us to
collect at any time (including Tenancy Tribunal orders, ratings/references, information relating to tenancy history, breaches
of the Residential Tenancies Act 1986 and updated information). This Privacy Statement does not limit your rights under the
Privacy Act 2020.
If you provide to us, or authorise us to collect, Personal Information about a third party (such as a guarantor or referee), you
confirm the relevant person has authorised us to collect, use and disclose their Personal Information in accordance with this
Privacy Statement and that you have informed them about their rights to access and or correct the Personal Information we
may hold about them. It is not mandatory to provide us, or authorise us to collect, Personal Information, however, if you do
not do so, it may affect the assessment of your tenancy application.
We may collect and use Personal Information to: (a) verify or allow for your identity to be verified (b) assess your
suitability for a tenancy, including assessing you and or your guarantor’s creditworthiness and references; (c) manage and
monitor your tenancy (if your application is approved); (d) assist with the collection of amounts outstanding in relation to
a Tenancy agreement; (e) check if you have overdue fines with the Ministry of Justice.
We may use the services of, or provide services to, illion (New Zealand) Limited, illion Tenancy Limited (illion Tenancy) and
their respective related companies (together Authorised Agencies). We may collect Personal Information from, and disclose
Personal Information to, Authorised Agencies for any of the purposes described in this Privacy Statement and we may
authorise Authorised Agencies to hold, use and disclose Personal Information for the purpose of providing their (or other
Authorised Agencies) services to us. Personal Information will be held by us in a digital form in New Zealand or in a country
that provides similar data protections to that of New Zealand (e.g., Australia).
You have the right to access and request correction of your Personal Information by contacting us at
[email protected] or making an online application at https://www.tenant.illiontenancy.co.nz/contact-us/
I confirm that all the information I have provided to you is accurate, complete, and not misleading and I have read,
understood, and agree to the Privacy Statement set out above.
Signed: Date signed: / /
Signed (Tenant #2): Date signed: / /
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Proof of Identity, Income and Address
**Please attach at least ‘one’ form of supporting documentation from ‘each’ category.**
Proof of Identity:
NZ Drivers Licence
Passport
18+ ID Card
Proof of Income:
Current Payslip
WINZ Statement
Proof of Current Address:
Utility Bill (Power / Gas / Internet/ Telephone)
Motor Vehicle Registration
Current Tenancy Agreement
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