TENANT PERSONAL DETAILS

Property Address which you are applying for:

Title:

First Name:

Middle Name:

Last Name:

Other Name(s): (Inc maiden name)

Date Of Birth:

National Insurance Number:

Residential Status: (please tick one)

Property Owner
Council Tenant
Private Tenant
Living with Friends/Relatives

Employment Status: (please tick one)

Employed
Self-employed
Retired
Independent Means
On Contract
Student
Unemployed

Gross Annual Income:

Telephone: (Inc STD)

Mobile:

E-mail:

Nationality:

Passport Number*:

Do you have any County Court Judgements, Court Decrees, Bankruptcy, Administration Orders,Involuntary Arrangements, or any other adverse credit history whether settled or not?

Yes
No

CURRENT & PREVIOUS ADDRESS(ES)

Current Address:

Postcode:

Period at address:

If you have lived at your current address for less than 3 years, please provide previous addresses below

Previous Address:

Postcode:

Period at address:

Address::

Postcode:

Period at address:

CURRENT LETTING AGENT/LANDLORD/MANAGING AGENT

Name:

Address:

Postcode:

Telephone (day):

Telephone (evening):

Fax:

E-mail:

FINANCIAL INFORMATION

Please tell us about your earnings and provide the details of a financial referee below (please tick one). Failure to provide your gross annual income will prevent us from contacting your referee and will delay your application.

Current Employer
Pension Administrator
Accountant
Self Assessment

Company Name:

Address:

Postcode:

Contact Name:

Contact’s Position:

Telephone: (Inc STD)

Fax:

E-mail:

Position Held:

Is this position:

Permanent
Contract
Contract Term
Months
Hrs per week

Payroll/Service/Pension Number:

Gross Salary/Pension/Drawings per annum:

Start Date:

End Date (if applicable):

Will your employment change before the proposed tenancy starts?

Yes
No

ADDITIONAL FINANCIAL INFORMATION - If you are changing to new employment, have a second job or another source of income,please provide details in this section.

Current Employer
Pension Administrator
Accountant
Self Assessment
Benefit/ Other

Company Name:

Address:

Postcode:

Contact Name:

Contact’s Position:

Telephone: (Inc STD)

Fax:

E-mail:

Position Held:

Is this position:

Permanent
Contract
Contract Term
Months
Hrs per week

Payroll/Service/Pension Number:

Gross Salary/Pension/Drawings per annum:

Start Date:

End Date (if applicable):

DECLARATION

Please read the declaration and sign and date below. WE CANNOT PROCEED WITH THIS APPLICATION IF YOU DO NOT SIGN.

I hereby confirm that the information provided by me is to the best of my knowledge true. I consent to this information being verified by contacting the third parties detailed in this form.I understand that the results of the findings will be forwarded to the appointed letting agent and/or landlord and may be accessed again should I default on my rental payment or apply for a new tenancy agreement in the future. I agree that Ellenbrook Estates Ltd or their approved agent may search the files of a Credit Reference Agency and IDS Ltd, the insurance industry's data collection agency, which will keep a record of that search. I confirm and agree that other information and checks that Ellenbrook Estates Ltd and/or other companies within the same group undertake as part of this process, such as employment/income and/or previous landlord or personal checks may also be provided to Credit Reference Agencies. I understand that I may request the name and address of the Credit Reference Agency to whom I may then apply for a copy of the information provided.

I also understand that in the event of my defaulting on the rental payment, that any such default may be recorded with the Credit Referencing Agency and IDS Ltd, who may supply the information to other credit companies or insurers in the quest for the responsible granting of tenancies, insurance and credit.

I understand that Ellenbrook Estates Ltd utilise the services of Credit Reference Agencies, and I consent to Ellenbrook Estates Ltd checking details held within those agencies for Tenant Vetting, Fraud Prevention, Identity and Anti-Money Laundering and also for the purposes of collections and recoveries where applicable.

I understand that in the event of any default by me in respect of the covenants in my tenancy agreement with my landlord, the information contained herein may be disclosed Ellenbrook Estates Ltd and/or one or more tracing companies and/or debt collection agencies in order to recover any monies due or to trace my whereabouts. I understand that the information provided by me may be transferred to a country outside of the EU for the purposes only of processing this referencing application, notwithstanding such transfer, Ellenbrook Estates Ltd will remain the Data Controller for the purposes of this application.

The information provided in this form by me is information as described in Ground 17 of the Housing Act 1996 and I understand that if any information within this application is found to be untrue, it is grounds for termination of the tenancy. I also understand that any default in the payment of rent may affect any future application for tenancies, credit or insurance and that the assessment of this application presumes that at some time during the tenancy agreement, I may be granted or allowed some form of deferred payment.

Your details may be used to keep you up to date on products and services related to your tenancy and creditworthiness by Ellenbrook Estates Ltd, your letting agent and those of carefully selected third parties, if you do not wish your details to be used for this purpose please write to us at 1 Walkden Road Walkden Manchester M28 3DA.

I hereby authorise my employer / accountant / pension administrator to provide details of my earnings and dates of employment to Ellenbrook Estates Ltd for the purposes described above.

Do you agree to this declaration?

Yes
No

Print name in full:

Date:

ADDITIONAL INFORMATION

Personal Details:

Marital Status:

Single
Married
Divorced/Separated
Other

Are you a smoker?

Yes
No

Do you have any pets?

Yes
No

Please detail:

Names and ages of any children who will be occupying the property (use a separate sheet if required):

Bank Details:

Name(s) of Account Holder(s):

Bank Name:

Branch Address:

Sort Code:

Bank Account Number:

Next of Kin (this should NOT be your spouse):

Name:

Address:

Post Code:

Telephone:

Relationship:

ADDITIONAL INFORMATION:

x