tenancy application form

If you wish to apply for renting a property, you can do so by filling in the form below.

Required fields are marked *

Personal Details

* Address applied for
* Phone
Mobile
Fax
* Email
* First Name
* Surname
* Date of birth
Full names of other occupants
(and their ages if under 18)

Indentification (Two Forms of ID Required)

* Please provide any two of the following forms of identification:
NZ Drivers Licence
NZ Income Support No
NZ Passport
NZ Birth Certificate
NZ IRD Number

Source of Income

Employer Name
Address
Phone Number
Position Held
Length of time with
current employer
Income per week
Other
(State full details, e.g. DSW)
If receiving a DSW benefit, enter benefit number
Office

Vehicle Details

Make and Model
Year
Colour
Registration Number

Insurance

* Do you have house contents
insurance with third party
liability cover? Yes No

Nearest Relative

Relationship (e.g. parent)
Full Name
Address
Phone Number
Employer
Employer's Phone Number

Bank Details

Bank Name
Branch
Account Number

Additional Information

* Any pets? Yes No
If yes, please list
* Do you or any intending
occupants smoke? Yes No

Your Present Address

* Address
* From (date)
* To (date)
* Present Landlord
* Landlord Phone

Agreement

PLEASE NOTE:Any documents you need to provide (e.g. rental references or forms of identification), must be presented in person when you come in to sign the tenancy agreement.
* I agree with Lugton's Terms and Conditions (click here to view) Yes No