This application form collects personal information about you.
This information is required for the purpose of:
Collecting information which may be provided to a tenant default database and/orcredit bureau if you enter into a tenancy agreement and fail to comply with the terms
of that agreement
Being made available to credit bureaux and/or tenant default databases and will beaccessible to other people that may inquire of this credit bureaux and/or tenant default
Failure to supply all the information in this form means you may not be considered for
I consent to you making any type of reference, verification or credit check including an
online TINZ check and associated databases.
I consent to you providing the information in this form and details of any proven breach of
my tenancy agreement or of the Residential Tenancies Act 1986 to any credit bureau or
tenant default database.
I acknowledge that the information may then be made publicly available through credit
bureau or tenant default databases if I have given anyone my authority to do checks on
these credit bureaux or tenant default databases or their checks otherwise conforms to the
terms of the Credit Reporting Privacy Code 2004.
I agree that you may use any of the information on this application form to enforce any
judgment in respect of the Tenancy Agreement or in respect of any order against me by
the Tenancy Tribunal.
I agree that an identification photo and an assessment regarding my fulfilment of basic
tenant responsibilities may be added to an internet based tenant reference website. This
assessment will be about how I/We performed regarding:
I agree that if I am declined this tenancy for reasons of a bad credit history or Tenancy
Tribunal orders against me, I am aware that this may be placed on a tenancy database.
I confirm the information in this form is true and correct and that I have read the Privacy
Act Statement as stated above.