Test Form


Address of the property you would like to rent:



Name:



Birth date:



LicenceNo:


Current Address Details:


Address:



City:



P/Code:



State:



Country:



Phone:



Fax:



Mobile:



E-mail:



Period of tenancy:



Weekly rent:



Landlord/Agent:


Please give the reasons you are leaving your current tenancy


Current Employment Details:


Occupation:



Employer:



Employer’s phone:



Period of Employment:


Next of Kin Details:


Name:



Relationship:



Adress:



Phone:


Reference 1 details:


Name:



Occupation:



Phone:


Reference 2 details:


Name:



Occupation:



Phone:


Tenancy details:


Number of adults:



Number of children: