2012-07-20





2

1

1

PRICE: $220pw

LOCATION: Ruakaka

ID # GGR57

LAND AREA:

This unit is perfect for a Single, couple or single with child.

New carpet and paint it has 2 bedrooms modern layout living/kitchen.

Best of all only meters from the Surf club, Cafe and Beach!

On the school bus route for Ruakaka Primary and Bream Bay College.

Make life easy and have power and Water included for further $20pw.

Moving costs 4 wks bond, 2wks Adv rent, 1 wks Let Fee + GST

Apply online below

Tenancy Application Form

Please fill the following form to apply for this property and we will get in touch with you shortly.

Property ID#*

Date Required

Applicant Details

Title

First Name*

Middle Name

Last Name*

Phone (daytime)*

Mobile

Email*

No. of Children

Please include children's ages.

Pets

Include breed if dog.

Smoking*

Yes

No

ID*

This can be drivers licence, passport or other id.

A copy must be supplied

Drivers Licence Number

Drivers Licence Version Number

Car Registration No.

Date of Birth*

Occupation

Occupation

Name of Employer

Address

Student

Yes

No

Institution

Course

Period of Employment

Business Phone

Source of income

Salary, Wages, Super, Benefit

Amount of income

$____________________ p/w

Spouse Details

Title

Full Name

Date of Birth

ID

This can be driver's licence, passport or other id.

Occupation of Spouse

Occupation

Name of Employer

Address

Student

Yes

No

Institution

Course

Period of Employment

Business Phone

Source of income

Salary, Wages, Super, Benefit

Amount of income

$____________________ p/w

Next of Kin

Name

Relationship

Address

Home Phone

Work Phone

Present Address

Present Address*

Period of Occupancy

Rent Paid

Name of Agent/Owner

Business Phone

Reason for Leaving

Previous Address

Address

Period of Occupancy

Rent Paid

Name of Agent/Owner

Business Phone

Reason for Leaving

Previous Convictions

Have you ever had an Order made against you by the Tenancy Tribunal?*

Yes

No

If Yes, for what reason?

Do you currently have any convictions or any court actions pending other than parking tickets or vehicle fines?*

Yes

No

If Yes, please explain

Is there any other reason that may affect your Tenancy Application?

Other Details

Please provide details of the vehicles that will be kept on the Property

Make, Model, Year, Registration

WINZ Client Number

Type of benefit

Community Services Card

Copy must be supplied

References

Please supply 3 references - Name & contact details of employers and previous landlords. NON family members must be supplied.

Bank Account Details

For Direct Debit authority

Bank & Brank

ie. Westpac - Ruakaka

Account Number

ie. 01-2345-6789012-34

Please read carefully before authorising

PRIVACY ACT 1993 STATEMENT
For the purposes of the Privacy Act 1993:
This application form collect personal information about you.
This information is required to assess your eligibility as a tenant and collects information which would be provided to a tenant default database or credit bureau if you enter into a tenancy agreement and fail to comply with the terms of that agreement. A tenant default database records the names of persons who have been found to breach a tenancy agreement or the Residential Tenancies Act 1986 by the Tenancy Tribunal. The information in the tenancy application form will, if you enter into a tenancy agreement with us, be held on a database and used by us and by the owner of the rented property.
The information will also be made available to credit bureau’s and tenant default databases.
If you do not supply all the information in this form, you may not be considered as a tenant for any of the properties we administer.
You have a right to see the information we hold about you and correct that information in accordance with the Privacy Act 1993.
You have a right to see the information held about you by any credit bureau or tenant default database and correct that information in accordance with the Privacy Act 1993.
I confirm the information in this form is true and correct and that I have read and understood all on the form including the Privacy Act 1993 statement above.
Should goodGround Real Estate Limited MREINZ Property Management introduce me/us to any premises which leads to me/us taking a tenancy I/we undertake to pay a letting fee of one weeks rent plus GST.
I/we hereby authorize goodGround Real Estate Limited MREINZ to use and disclose my/our personal information in accordance with the above Privacy Act 1993.
I/We the applicant/s do solemnly and sincerely declare that the information provided is true and correct.
I/We also acknowledge and accept that if this application is not successful, the Agent is not obliged to give reasons.
I/We also acknowledge that if unsuccessful, this application will be destroyed. 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 publicly accessible through credit bureau or tenant default databases.
I agree that you may use the information on this form to enforce any judgment in respect of the Tenancy Agreement or in respect of any order made against me made by the Tenancy Tribunal.

Applicant's Authorisation

please type full name

Please tick to show that you authorise us to proceed with your application

Yes

Please tick to show that you have read and understood the Privacy Act Statement above and that all information provided in this form is true and correct

Yes

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