IPM Pre-Tenancy Application Form

IPM Pre-Tenancy Application Form

This information is required for the purposes of assessing your eligibility as a tenant. One form should be completed for every intending adult tenant.
- Property Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Special requirement?
- Car Registration
- Make and Model
- Please choose one
  
  I am a new applicantI am an existing or previous tenant of IPM LtdI have made application beforeThis is a join applicationOther
- Full Legal Name
  
  First NameMiddle NameLast Name
- Other names you have been known by
  
  First NameMiddle NameLast Name
- Other names you have been known by 2
  
  First NameMiddle NameLast Name
- Date of Birth
  
  DayMonthYear
- Passport or drivers' license no.
  include version number if any
- Nationality
- NZ Visa Type
  Attach proof of expiry date
- Visa expiry date
  
  DayMonthYear
- Upload suitable ID and relevant documents
  
  Upload a File
  
  Cancelof
- Bank Account No:
- Applicant's Current Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Phone Number
  
  Area CodePhone Number
- Mobile Number
  
  Area CodePhone Number
- E-mail
- Proof of current address
  
  Upload a File
  
  Cancelof
- Have you ever been convicted or found guilty of any offence against the law of New Zealand or any other country?
  
  YesNo
- Have you ever had a protection order issued against you?
  
  YesNo
- Emergency Contact
  
  First NameLast Name
- Phone Number
  
  Area CodePhone Number
- Please provide your rental details for at least the last 3 years.
- Applicant's Address 1
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Date In
  
  DayMonthYear
- Date Out
  
  DayMonthYear
- Reason for moving
- Property Management Company
- Landlord / Manager
  
  First NameLast Name
- Phone Number
  
  Area CodePhone Number
- Applicant's Address 2
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Date In
  
  DayMonthYear
- Date Out
  
  DayMonthYear
- Reason for moving
- Property Management Company
- Landlord / Manager
  
  First NameLast Name
- Phone Number
  
  Area CodePhone Number
- Company's Name
- Present Occupation
- Contact / HR
  
  First NameLast Name
- Phone Number
  
  Area CodePhone Number
- Office Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Start Date
  
  DayMonthYear
- End Date (if applicable)
  
  DayMonthYear
- If you are currently receiving your income from Work & Income New Zealand, please provide your customer number and benefit type;
- We require 2 contact names and details - they cannot be family members nor people you intent to have living with you.
- It is very important that you read and understand the content of this section before you submit an application. If in doubt please check with your solicitor.
- PRIVACY ACT 1993 STATEMENT
  
  This application form collectspersonal information about you.
  
  This information is required to:
  - Assess your eligibility as a tenant; and
  - Collect information, which would be provided to a tenant default database and/or bureau if you enter into a tenancy agreement and fail to comply with the terms of the agreement. (A tenant default database records the names of the persons who have been found in breach of their tenancy agreement and/or the Residential Tenancies Act 1986 by the Tenancy Tribunal);
  - The information in this tenancy application form will be retained within our office;
  - The information will also be made available to credit bureau and/or tenant default database and will be accessible to other people that may inquire of this credit bureau and/or tenant default database
  - If you do not supply all the information in this form, you may not be considered for a tenancy.
  - You have a right to see the information held about you by any credit bureau or tenant default database and to correct that information in accordance with the Privacy Act.
  Acceptance
  1. I consent to you making any type of reference, verification or credit check including an online TINZ check and associated database.
  2. I consent to you providing the information in this form and details of any proven breach of my tenancy agreement or of the Residential Tenancy Act 1986 to any credit bureau or tenant default database.
  3. I acknowledge that the information may then be made publicly available through credit bureau or tenant default database.
  4. I agree that you may use any of the information on this application form to enforce any judgement in respectof any order against me by the Tenancy Tribunal.
  5. I agree that an identification photo and an assessment regarding my fulfillment of basic tenant responsibilities may be added to an internet based tenant reference website. This assessment will be about how I/We perform regarding;
    
    Payment of rent
    
    Keeping the dwelling and grounds tidy
    
    Are considerate towards neighbors
    
    Leave the dwelling and grounds tidy
  6. 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.
  7. I confirm the information in this form is true and correct and that I have read the Privacy Act Statement as stated above.
- Signature
  
  Clear
- Should be Empty: