Enter Full name:*

Date of Birth:*

Telephone Number:*

Email Address:*

If the application is joint, please provide the seconds applicants details:

Enter Full name:

Date of Birth:

Telephone Number:

Email Address:

Number of people over the age of 18 living at the property:
Please Select12345 or more

Right to Rent:
As of 1st of February 2016 all landlords must carry out a "Right to Rent check". Please read this document carefully and confirm which forms of documentation you will be providing. Click here to open the PDF for more information
PLEASE NOTE YOU WILL BE REQUIRED TO SHOW ORIGINALS PRIOR TO MOVING INTO THE PROPERTY.
Please upload copies of your documentation here (max 4) and select from the drop down list to confirm which List they pertain to:
Please selectList A (Group 1): Acceptable single documents which show an unlimited right to rentList A (Group 2): Acceptable document combinations which show an unlimited right to rent (any 2 of the below to be shown in combination)List B: Documents which show a time-limited right to rent




Property address applying for:*

Preferred start date of tenancy:*

Agreed Rental Amount:*

Which of the following are you:*
Please selectHomeownerPrivate tenantLiving with relatives
Current property address
Street Address 1:*

Street Address 2:*

City/Town:*

Post Code:*

Dates previous address 1
From:*

To:*

Reasons for leaving (If applicable):

If you have lived at your current address for less than 3 years, please provide details
Previous property address
Street Address 1:

Street Address 2:

City/Town:

Post Code:

Dates at previous address 2
From:

To:

Name and address of current landlord (If applicable)
Salutation:
MrMrsMsMiss
Landlord’s name:

Address
Street Address 1:

Street Address 2:

City/Town:

Post Code:

Telephone Number:

Email address:

Housing Benefit
Will you be receiving any assistance to pay the rent?*
Please selectYesNo
If Yes, please complete this section
Have you ever received housing benefit before:
Please selectYesNo
Housing benefit officers name:

Housing benefit entitlement:

Difference to be paid by you:

Application/Benefit reference number:

Are you entitled to be part of the Deposit Guarantee Scheme (DGS):
Please selectYesNo
Employment Details
Which of the following are you:*
Please selectFull time employedPart time employedTemporary ContractSelf-employedUnemployed
Length of service with current employer (If applicable):

Name and address of current employer (If applicable)
Company Name:

Position held:

Employer address
Street Address 1:

Street Address 2:

City/Town:

Post Code:

Employer Contact Details (If applicable)
Salutation
MrMrsMsMiss
Contact's name:

Contact’s position:

Telephone Number:

Email address:

Your annual gross salary (£) (please include any bonuses):

National Insurance Number/Passport Number
National Insurance number:

Passport number:

Bank Account Information
Account in the name of:*

Account number:*

Sort Code:*

Do you have any criminal convictions?*
SelectYesNo
Do you have any County Court Judgements or rent arrears?*
SelectYesNo
Reference Contact Details 1
Relationship to you:*

Salutation:*
MrMrsMsMiss
Referee’s name:*

Address:*
Street Address 1:*

Street Address 2:

City/Town:*

Post Code:*

Telephone Number:*

Email address:

Reference Contact Details 2
Relationship to you:

Salutation:
MrMrsMsMiss
Referee’s name:

Address:
Street Address 1:

Street Address 2:

City/Town:

Post Code:

Telephone Number:

Email address:

Next of kin details
Relationship to you:*

Salutation:*
MrMrsMsMiss
Next of kin's name:*

Address:
Street Address 1:*

Street Address 2:

City/Town:*

Post Code:*

Telephone Number:*

Email address:

Personal Reference
Relationship to you:

Salutation:
MrMrsMsMiss
Personal referee’s name:

Address:
Street Address 1:

Street Address 2:

City/Town:

Post Code:

Telephone Number:

Email address:

For company lets or self-employed tenants only
Accountant or solicitor's details:
Salutation:
MrMrsMsMiss
Accountant or solicitor's name:

Address:
Street Address 1:

Street Address 2:

City/Town:

Post Code:<

Telephone Number:

Email address:

For company lets or self-employed tenants only
Trade Reference
Salutation:
MrMrsMsMiss
Trade referee’s name:

Address
Street Address 1:

Street Address 2:

City/Town:

Post Code:

Telephone Number:

Email address:


Declaration
The information, which I have given in my Application Form, is true to the best of my knowledge. I consent to this information being verified by fair and lawful means, which I understand will involve contacting referees and licensed credit reference agencies. I understand that my application form and the resulting verified information would be forwarded to the letting agency and / or to the landlord. The results may also be accessed again if I apply for a tenancy in the future.
I consent to Elcap LLP searching information held by credit reference agency and agree that Eclap LLP and the credit-referencing bureau will keep a record of that search and the results from that search. The results of that search may show how I conduct my payments including rental payments and this may also be disclosed to the agency and may affect future credit applications from me and / or from members of my household and from time-to-time such information may be used for debt tracing and fraud prevention.
I hereby expressly consent to my personal details, including all recorded details in this application form, and any forwarding address(es) at the determination of any tenancy being passed to the landlord and / or to the utility companies and / or to the local authority. Otherwise all information will be treated as confidential.
I consent to the information contained in my Application Form being used by Reference-my-tenant and its business partners to notify me of other products and services as appropriate.
I agree that information supplied by me will be held in accordance with the Company’s notification under the Data Protection Act 1998. That you may record sensitive data as defined in the Data Protection Act 1998 and I understand that I have the right to ask for a copy of the information held about me subject to the payment of an administration fee that will be notified to me upon application, though it will not exceed the amount set by statute. I have the right to request that the information on me be amended if it is found to be incorrect. I also consent to passing my application forms and the results of any such search or assessment to my prospective landlord(s) for the purpose of assessing this application. I understand that if my reference is declined I will not be given a refund of my application fee.
By clicking on the acceptance button you acknowledge that you have read and agree to be bound by the above declaration. Please click here to accept:

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