RESIDENTIAL TENANCY APPLICATION

Landlords’ Association (S.A.) Inc. – Notice 2

Landlord Name(s)………………………………………………………………………………………………….

Contact Details …………………………………………………………………………………………………….

Property Details:
Address of Rental Property: ………………………………………………………………………………………..

………………………………………………………………………………………………………………………….

Rent per week: $ Term of lease to be negotiated

Period required 6 mths 12 mths Other………………………..
Bond: $

No. of persons to occupy premises:

Anticipated date of commencement:

Personal Information Full Name: Mr / Ms / Miss / Mrs / Other

Applicant…………………………………………………………… Date of Birth:……………………..

Before any application will be considered each applicant must achieve a minimum of 100 check points for
ID purposes. In addition the following documentation MUST be provided. See end of page 4 for details.
Proof of income (e.g. current pay slips,) Copy of Drivers Licence or Photo ID

Current Address : Length of time at this address:

Driver’s License or Photo ID Number: Medicare No:

(Please attach a copy)

Passport No:
Pension No. (if applicable):……………………………
 DSP,  Veterans Affairs,
Type of Pension:
 Age Pension,  Parenting Payment Single
 Parenting Payment Partnered
Current copy of your income statement must be provided

Home Phone No : Mobile No:

Name of next of Kin: Relationship:

Contact in case of emergency : Phone No:

Notice 2 – Revised Jun 2015 Page 1 of 4

This form is Copyright and the format remains the property of the Landlords’ Association (S.A.) Inc
Employment Details Name of Employer:

Occupation: Employer’s Address:

Length of employment:
Contact Name of Employer: Phone No:

Income details: Source of income  Wages  Centrelink  Other(please provide details)

Net weekly income : $

Please attach a copy of your income statement

Applicant History Phone No: Rental Period:
Name of current Landlord/Agent:
Address:

Previous Landlord/Agent: Phone No: Rental Period:

Address:

Previous Landlord/Agent: Phone No: Rental Period:

Address:

Rental History
Why did you leave or why are leaving this address?

Was the bond refunded in full? Yes  No 

If no, why?

Have you ever attended a Residential Tenancies Tribunal hearing? Yes  No 

If yes, please provide details:

Business Referees

Name: Phone No:

Name: Phone No:

Personal Referees
Phone No:
Name:

Name: Phone No:

Vehicles
Please describe all vehicles/boats/trailers/motorbikes/caravans etc. to be parked on the property

Vehicle Make: Registration No:

Vehicle Make: Registration No:

Notice 2 – Revised Jun 2015 Page 2 of 4

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Accommodation Details
Do you have shared or joint custody of children? Yes  No 
If yes, please provide full names of the children and provide details of the period of time they will be
occupying the property.

Full Name: Date of Birth:

Full Name: Date of Birth:

Full Name: Date of Birth;

Pets

Is it your intention to seek approval for permission to keep a cat, dog or other pet at the property?
Yes  No 
If yes, please provide details………………………………………………………………………….....

If you have a dog please provide details of Council Registration……………………………..........................

Please note that in some circumstances including under the Strata and /or Community Title Act pets may
not be permitted and you will need to discuss this with the landlord.

Do you smoke : Yes  No 

Smoking is not permitted inside the dwelling

This following section requires completion if you are a student

College, TAFE or University: Faculty/Course:

Student ID No:

Student Union No:

Income sources:

Student Visa Expiry Date: (copy of Visa will need to be supplied)

Notice 2 – Revised Jun 2015 Page 3 of 4

This form is Copyright and the format remains the property of the Landlords’ Association (S.A.) Inc
Privacy Statement
We collect personal information about you in this form to assess your application for a residential tenancy. We may
need to collect information about you from your previous Landlords or Letting Agents, the Landlords’ Association (S.A.)
Inc., your current Employer and your Referees. We also check whether any details of tenancy defaults by you are held
on a tenancy default database. Your consent to us collecting this information is set out below.
If this application is successful we may disclose your details to service providers relevant to the tenancy relationship
including Maintenance Contractors, Insurers and the Landlords’ Association (S.A.) Inc.
You have the right to access personal information that we hold about you or which is held by the Landlords’
Association (S.A.) Inc. If you do not sign this form then your application for a residential tenancy may not be
considered or, if considered, may be rejected. Although not bound by the Privacy Act, the Landlords’ Association (S.A.)
Incorporated respects the national privacy principles.
Privacy Consent
1. I, the Applicant, acknowledge that I have read and understand this form and I hereby authorize you and the
Landlords’ Association (S.A.) Inc. to collect information about me from:
• My previous Letting Agents and/or Landlords
• My Employer/Personal Referees
• Any tenancy default database which may contain personal information about me.
I also authorize you and the Landlords’ Association (S.A.) Inc. to disclose details about any defaults by me under the
tenancy to which this application relates to any tenancy default database.
I understand this information may be used to assess my application.

2. I also authorize you to disclose my personal details if requested to Financial Services, Insurance Services, Utilities,
Trades People, Real Estate Agents and Body Corporate (Strata Corporation or Community Corporation) other
Landlords and Debt Collectors.

Full Name: ____________________________________________________________

Signature: ________________________________________ Date: _______________

Declaration
1. I, the Applicant, hereby offer to rent the property from the Landlord under a lease prepared by the Landlord. I
acknowledge that this application is subject to the approval of the Landlord and if accepted I will be required to pay two
weeks rent and a rental bond equivalent to 4 to 6 weeks rent dependent on rental figure in terms of the Residential
Tenancies Act (1995).
2. I declare that all information contained in this application is true and correct.
3. I understand that this agreement is binding upon advice that the application has been accepted by the
Landlord. I undertake to enter into a written Residential Tenancy Agreement in accordance with the Residential
Tenancies Act (1995). I will be required to pay the rent, costs, damages, etc. due and payable under the agreement.
4. I acknowledge that the Landlords’ Insurance policy will NOT cover the tenant’s contents and that the tenants should
obtain contents and public liability insurance.
5. I acknowledge that the Landlord has the right to increase rent during the term of a fixed term tenancy in accordance
with the Residential Tenancy Act (1995).
6. I understand that I will only be contacted if this application is successful

Signature: ________________________________________ Date: ________________

Disclaimer: The Person issuing this application form to you is not the Landlords’ Association (S.A.) Inc. It is the
prospective Landlord.

Before any application will be considered, each applicant must achieve a minimum of 100 check points
Last 4 rent receipts #50 points Copy of Birth Certificate #30 points
Passport #50 points Min 2 References from previous LL/Agent #20 points
Driver’s licence #40 points Current Motor Vehicle Registration papers #10 points
Medicare card #30 points Copy of Telstra, AGL, Bank Statement #10 points
Photo ID #30 points Copy of Travel Visa #10 points
Copy of Telecommunication, Electricity, Gas Bills #10 points

Notice 2 – Revised Jun 2015 Page 4 of 4

This form is Copyright and the format remains the property of the Landlords’ Association (S.A.) Inc