Application for Tenancy

Download a printable version here.

Property Address

Applicant Name

NOTE: All occupants 18 years and over must complete an application form

Names of other applicant’s

Date Inspected

Rent $ (per week)

During my inspection of the property I found it to be in a reasonably clean condition YesNo

If NO I believe the following items should be attended to prior to the commencement of my tenancy if approved. I acknowledge that these items are subject to landlords approval.

I declare the following:

  1. That if accepted a holding deposit of one week’s rent will be paid to Harper Property Agents within 24 hours of acceptance. The holding fee is to be paid by Bank Cheque, money order or direct deposit to the trust account of Harper Property Agents. I acknowledge the holding fee terms as per part K of this application.
  2. If approved I acknowledge that no key will be provided to the property until all monies owed have been paid.
  3. I acknowledge that the availability of telephone/internet/digital or cable television and the adequacy of such services at the property are the sole responsibility of the tenant.
  4. I understand and agree that should this application be rejected Harper Property Agents are not obligated to give a reason for the rejection.
  5. If approved rental payment are to be made by Direct Debit to the agents trust account in advance in accordance with the Residential Tenancy Agreement.

Applicant Full Name

Applicants Signature


100 Points of identification to be included with your application

Drivers Licence/18+ Card/Passport (one of these must be provided) 30 points each
Tenant ledger/Tenancy Agreement/4 x Rent receipts/Bond receipt 20 points each
Pay slip/Vehicle Registration/Phone, Electricity or Gas account 15 points each
Bank statement/Pension or Health card/Council or Water Rates 15 points
Medicare Card/ Birth Certificate 10 points

NOTE: Incomplete applications will not be processed

Completed application to be emailed to

Rental Reference Request

The below tenant has applied for a rental property and advised that they have previously rented through your agency. It would be greatly appreciated if you could complete the reference and return to with a tenant rent ledger. Privacy Statement attached.


Address of rented premises


Period of tenancy

Rent Amount
per week

Was the rent paid on time? YesNo Please attach rent Ledger
Have they vacated? YesNo
If yes, was the property left clean and undamaged? YesNo
Was the bond refunded in full? YesNo
Terminations notices issued? YesNo If yes, what grounds
Did the tenant have pets? YesNo If yes, any damage cause by pets?
Any complaints received from neighbors YesNo
Periodic inspections conducted? YesNo How Often
Was the property kept in an acceptable condition?
(Including lawns & Gardens)
Would you rent to this tenant again? YesNo

Completed by (Name)


Thank you for your assistance

Kind Regards,
Amanda Reid

Ph: 1300 626111

Residential Application Form

A. Agent Details

Harper Property Agents

Address: Level 2, 49 Annie Street Wickham, NSW 293
Phone: 1300 626 111

B. Property Details

1. What is the address of the property you would like to rent


2. Lease commencement date?




3. Lease term?



4. How many tenants will occupy the property?



Ages of children

C. Personal Details

5. Please give us your details



Given Name/s

Date of Birth

Driver's License number

Driver's License expiry date

Driver's License state

Passport No.

Passport Country

Pension No. (if applicable)

Pension type (if applicable)

6. Please provide your contact details

Home phone no.

Mobile phone no.

Work phone no.

Fax no.

Email Address

7. What is your current address?


8. How did you find out about this property?

NewspaperThe InternetLocal PaperOfficeOffice WindowSign Board at propertyReferral
Other (specify)

Application sent to Direct Connect (if Required)

D. Utility Connections

This is a FREE service that connects all your utilities and other services.

Direct Connect can help arrange for the connection or provision of the following utilities and other services:

  • Electricity
  • Gas
  • Phone
  • Internet
  • Pay TV
  • Cleaners
  • Insurance
  • Removalist
  • Truck or van hire

Please tick this box if you would like Direct Connect to contact you in relation to any of the above utilities and other services.

The Always ON GuaranteeWe guarantee that when you connect with one of our market leading electricity and gas suppliers, your services will be connected on the day you move in. Please refer to Direct Connect's Terms & Conditions for further information.
Once Direct Connect has received this application Direct Connect will call you to confirm your details. Direct Connect will make all reasonable efforts to contact you within 24hours of the nearest working day on receipt of this application to confirm your information and explain the details of the services offered. Direct Connect is a one stop connection service. Direct Connect's services are free. However, the relevant service providers may charge you a standard connection fee as well as ongoing service charges.

DECLARATION AND EXECUTION: By signing this application, you:

  1. Acknowledge and accept the Direct Connect's Terms and Conditions (which are included with this application).
  2. Invite Direct Connect to contact you by any means (including by telephone or SMS even if the Customer's telehpone number is on the Do Not Call Register) in order to provide Direct Connect's services to you, to enter into negotiations with you relating to the supply of relevant services listed above. This consent will continue for a period of 1 year from the date the Customer enters into the Agreement.
  3. Concent to Direct Connect using the information provided by you in this application to arrage for the nominated services, including by providing that information to service providers for this purpose. Where service providers are engaged by you, they may use this information to connect, supply and charge you for their services.
  4. Authorise Direct Connect to obtain the National Metering Identifier and/or the Meter Installation Reference Number for the premises you are moving to.
  5. Agree that, except to the extent provided in the Terms and Conditions, Direct Connect has no responsibility to you for the connection or supply (or the failure to connect or supply) any of the services.
  6. Acknowledge that Direct Connect may receive a fee from service providers, part of which may be paid to the real estate agent or to another person, and that you are not entitles to any part of any such fee.

By signing this application form, I warrant that I am authorised to make this application and to provide the invitations, consents, acknowledgements, authorisations and other undertakings set out in this application on behalf of all applicants listed on this application.



PO Box 1519, Box Hill, Victoria 3128. P: 1300 664 715 F: 1300 664 185.

E. Declaration
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 residence;
(b) My personal referees and employer/s;
(c) Any record listing or database of defaults by tenants such as NTD, TICA or TRA for the purpose of checking your tenancy history;
Iam aware that I may access my personal information by contacting
  • NTD: 1300 563 826
  • TICA: 1902 220 346
  • TRA: (02) 9363 9244
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 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)
(g) complete a credit check with NTD (National Tenancies Database)

I am aware that information is not provided or do i not consent to the uses to which personal information is put, the Agent cannot provide me with the lease/tenancy of the premises.



F. Applicant History

9. How long have you lived at your current address?



10. Why are you leaving this address?

11. Landlord/Agent details of this property (if applicable)

Name of landlord or agent

Landlord/agent's phone no.
Weekly Rent Paid

12. What was your previous residential address?


13. How long did you live at this address?



14. Landlord/Agent details of this property (if applicable)

Name of landlord or agent

Landlord/agent's phone no.
Weekly Rent Paid
Was bond refunded in full?
If not, why not?

G. Employment History

15. Please provide your employment details

What is your occupation?

What is the nature of your employment?

Employer's name (inc. accountant if self employed or institution if student)

Employer's address

Contact name

Phone no.

Length of employment



Net Income

16. Please provide your previous employment details

Employer's name

Contact name

Phone no.

Length of employment



Net Income

H. Contact/References

17. Please provide a contact in case of emergency


Given name/s

Relationship to you

Phone no.

18. Please provide 2 personal references (not related to you)

1. Surname

Given name/s

Relationship to you

Phone no.

2. Surname

Given name/s

Relationship to you

Phone no.

I. Other Information

19. Car Registration

20. Please provide any details of pets

1. Breed/type
Council registration/number

2. Breed/type

Council registration/number

J. Payment Details

Property rental (per week)

First payment of rent in advance

Rental bond (4 weeks rent)


Less: Holding deposit (see below)

Amount payabale on signing tenancy agreement
(bank cheque or money order only)

K. Holding Fee

The holding fee can only be accepted after the application for tenancy is approved.

The holding fee (not exceeding 1 week's rent) of ___________ keeps the premises off the market for the prospective tenant for 7 days (or longer by agreement).
In consideration of the above holding fee paid by the prospective tenant, the landlord's agent acknowledges that:
(i) The application for tenancy has been approved by the landlord; and
(ii) The premises will not be let during the above period, pending the making of a residential tenancy agreement; and
(iii) If the prospective tenant(s) decide not to enter into such an agreement, the landlord may retain the whole fee; and
(iv) If a residential tenancy agreement is entered into, the holding fee is to be paid towards rent for the residential premises concerned.
(v) The whole of the fee will be refunded to the prospective tenant if:
(a) the entering into of the residential tenancy agreement is conditional on the landlord carrying out repairs or other work and the landlord does not carry out the repairs or other work during the specified period
(b) the landlord/landlord's agent have failes to disclose a material fact(s) or made misrepresentation(s) before entering into the residential tenancy agreement.

Signature of Landlords agent


Signature of Applicant