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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 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
default database, and to agents/landlords of properties
I may apply for in the 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 tradespeople 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)
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.
If section D is completed, I consent to the disclosure
of this page of the
application form to UtilityOne Corporation ACN 096 897 880
for the
purpose of enabling UtilityOne to offer the connection and
disconnection
services to me. Where UtilityOne is requested to arrange
for the provision
of the services, I consent to UtilityOne disclosing personal
information it
has collected about me to utility service providers for
that purpose and to
obtain confirmation of the connection or disconnection.
I consent to
UtilityOne disclosing confirmation details (including NMI,
MIRN, telephone
number, water company) to the Agent. I acknowledge that
neither
UtilityOne nor the Agent accepts any responsibility for:
any delay in, 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 acknowledge that
the Agent, its employees and UtilityOne may receive a fee/benefit
from a
service provider in relation to the connection of a utility
service.
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