APPLICANT
DETAILS
1. Title:
Mr/Mrs/Ms/Dr/Other
2. Name:
(Forename then Surname)
3. Former Names:
(if any)
4. Date & place of birth:
5. Contact telephone numbers:
6. Email address:
7. Are you a smoker ?
Yes/No
CURRENT ADDRESS
8. What is your current address ? (please
include postcode)
9. How long have you lived there ?
years/months
If less than five years, please
give previous addresses, including postcodes
13. Is current property owned or rented ?
(Owned/Rented/Living with Family/Other -
specify details)
LANDLORD / AGENT DETAILS
14. If rented, what is the name of your current
Landlord or Agent ? (Enter details of the one to whom you are
paying the rent)
15. What is your Landlord/Agent's address ?
16. What is your Landlord/Agent's telephone / fax numbers ?
17. What is your Landlord/Agent's email address ?
18. Why are you leaving ?
NEXT OF KIN
19. What is the name and relationship of your next of kin
?
20. What is their address ?
21. What is their telephone number ?
PROPERTY SOUGHT
22. What is the
address of the property would you like to rent
?
23. What monthly rental has been agreed ?
24. When would you like to move in ?
eg. ASAP
25. If any other person is likely to be staying at the property, please give
their names and ages
26. If you have any pets that will be staying at or visiting the property,
please give full details
(Put none if appropriate)
EMPLOYER DETAILS
27. What is the name your current employer ?
28. What is your employer's address ?
29. Whom should we contact for confirmation of your employment status ?
30. What is your employer's telephone number ?
31. What is your employer's fax number ?
32. What is your employer's email address ?
EMPLOYMENT DETAILS
33. What is your gross monthly income ?
(MONTHLY Salary
BEFORE tax)
34. What is your position ?
35. How long have you worked for your current employer ?
Years / Months
36. Is your employment permanent ?
(Permanent / Temporary)
37. Do you work full time ?
(Full time / Part time /Agency)
38. What is your National Insurance Number ?
If self employed, please give details of
your accountant
ACCOUNTANT DETAILS
39. Accountant's Name:
40. Accountant's Address:
41. Accountant's Tel:
42. Accountant's Fax:
43. Accountant's Email:
Application and Declaration
I hereby apply for an Experian Credit Status Report and Tenancy as per the
above details and declare that,
to the best of my knowledge and belief, all of
the information provided by me is true.
I hereby
authorise Priority Management Services Ltd to obtain relevant information,
including salary details and employment terms to support this application.
I confirm
there have been no County Court Judgements, bankruptcy orders or similar
against me
during the past five years and understand my holding deposit will be forfeit
(a) should I withdraw my application for any reason,
(b) if a change in my circumstances forces the landlord to withdraw
(c) or any of the information provided by me is in any way misleading or
inaccurate.
I understand
that by submitting this form I am bound by the above-mentioned terms.
Full name of applicant
Application Date