TENANT APPLICATION ONLINE:

Mobile. 0212888342
Phone: 09 889 3805
PLEASE SCAN TO EMAIL OR FAX 2999829 Email: info@mpsl.org.nz

PROPERTY APPLYING FOR ______________________________________________________________________

FIRST APPLICANT: Last Name: ________________________ First Name:___________________ male / female

Phone Numbers ____________________(work) __________________________(home)

____________________(mob) (e-mail)

Date of Birth _____________________________ Marital Status: _________________

License/Passport Number: __________________ Cars ________ Registration Numbers:___________________

Present Address: ___________________________________________________Date Moved In: ____/____/____

Previous Address: __________________________________________________ Date Moved In: ____/____/____

Do you have pets? Y / N Breed______________________________ ARE ANY OCCUPANTS SMOKERS Y / N

Total Number of Adults ______________ Number of Children ____________ Ages/Sex______________________

Period Required: __________ Date Required: ___________ Reason for moving: _________________________

Beneficiary NZISS Card Number ______________________ Type of Benefit ___________________________

WORK DETAILS Place of Employment:______________________________________

Occupation: __________________________________ Supervisor___________________________________

Work Address: _________________________________________________________ Start Date ___/____/____

PARTNER / SECOND APPLICANT Name: _____________________________________ Date of Birth ___/____/____

Current Address: _______________________________________________________ Mobile ______________

Place of Employment: ________________________________ Phone: _____________ Start Date ___/____/___

Address: _______________________________ Occupation: _______________ Supervisor ________________

FLATMATES Full Name Work Place Mobile Ph Date of Birth
1. _______________________ ________________________________ __________________ ____ / ___ / ____

2. _______________________ ________________________________ __________________ ___ / ___ / ____

3. _______________________ ________________________________ __________________ ___ / ___ / ____

NEXT OF KIN (Not Living with you)
Name: ______________________________________________________ Relationship ________________________________
Address: ___________________________________ ________________________ Phone: ________________
EMERGENCY CONTACT
Name:____________________________________________________ Relationship _______________________________________________
Address: __________________________________________________________________________ Phone: __________________________
REFERENCES
Previous Landlord: _____________________________________________________ Phone Number: ________________________________

Personal: _____________________________________________________________ Phone Number: ________________________________

Personal: _____________________________________________________________ Phone Number: ________________________________

FEE
I/We appoint Mobile Property Sales & Letting, MPSL (twrera) to be my/our agent and agree to pay a fee of one weeks rent plus GST. I acknowledge to MPSL that
if I decide to withdraw after I have verbally agreed to take the property, that I am liable for a cancellation fee, not exceeding one weeks rent.
CREDIT CHECK
I/We authorise any person or company to provide you with such information as you may require in response to your credit and/or employment enquires. I/We
further authorise you to furnish to any third party details of this application and any subsequent dealings that I/we may have with you as a result of this application
being actioned by you.

Signed: _____________________________________________________ Date: _____________________