PROPERTY DETAILS YOU WANT TO RENT (* required)
Property Street address *
Suburb/Town *
Postcode *

Lease Commencement Date? *		Click to enter date
Lease terms (months)
Rent (months)

Number of occupants *		Adults
		Children

PERSONAL DETAILS

Title	Choose Mr Ms Miss Mrs Other
First name *
Last name *
Date of birth	31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 09 08 07 06 05 04 03 02 01 Day Month Jan Feb March April May June July Aug Sept Oct Nov Dec Year 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900
Contact number - BH *
Contact number - AH *
Mobile number
Facsimile
Email *

Pets *

Yes

No

If yes, what breed or type?
Council Registration number?

IDENTIFICATION

Current drivers licence or passport number *
State of licence or country of passport *
ABN/ACN number if self-employed

APPLICANT HISTORY

Current address *
How long have you lived at your current address? *
Why are you leaving this address? *

Landlord/Agent details*
Contact number - BH *
Mobile number

Length of stay (months)*

Rent - monthly *

Is your rent paid up to date?

Yes

No

PREVIOUS LANDLORD/AGENT

Previous address
Landlord/Agent
Contact number - BH
Mobile number

Length of stay (months)

Rent - monthly

Was bond refunded in full? If not why not?

EMPLOYMENT HISTORY

Current employer
Contact
Contact number
Mobile number
Employers address
Suburb/Town
Postcode

Length of employment

Income

PREVIOUS OCCUPATION (if employed at your current job for less than two years)

Previous employer
Contact
Contact number
Mobile number
Employers address
Suburb/Town
Postcode

Employment period

Income

PROFESSIONAL REFERENCES

Reference 1
Name
Address
Contact number

Reference 2
Name
Address
Contact number

EMERGENCY INFORMATION

Next of kin *
Relationship *
Address *
Contact number *

SEND APPLICATION

DECLARATION

I have Read and agree to the terms and conditions

PRIVACY ACT Click Here for a PDF file.

Due to recent changes in Privacy Laws, from December 21, 2001 all property managers must ensure that you fully understand the National Privacy Principals and the manner in which we must use your private information in order to carry out our role as professional property managers. Please take the time to read this Privacy Statement carefully, and once completed, return it to this office with your tenancy application.

As professional property managers LEEBURN & COMPANY SALES PTY LTD collects personal information about you. To ascertain what personal information we have about you, you can contact us by:
TELEPHONE: 9744 1455
FAX: 9744 4465
EMAIL: LEEBURN@LEEBURN.COM.AU
IN PERSON: 50 EVANS STREET, SUNBURY
WEBSITE: WWW.LEEBURN.COM.AU

PRIMARY PURPOSE

As professional property managers, we collect your personal information to assess the risk in providing you with the lease / tenancy of the premises you have requested, and if the risk is considered acceptable, to provide you with the lease / tenancy of the premises.

To carry out this role, and during the term of your tenancy, we usually disclose your personal information to:
* The Landlord
* The landlords lawyers
* The landlords mortgagee
* Referees you have nominated
* Organisations / Trades people required to carry out maintenance to the premises
* Rental Bond Authorities
* Residential Tenancy Tribunals/Courts
* Collection Agents
* National Tenancy Database Pty Ltd (ABN 65 079 105 025) (“ntd”)
* Other Real Estate Agents & Landlords

SECONDARY PURPOSES

We also collect your personal information to: Tick each box if you consent to the use and disclosure

Enable us, or the Landlord’s lawyers, to prepare the lease/
tenancy documents for the premises
Allow organisations / trades people to contact you in relation
to maintenance matters relating to the premises

Leeburn & Company Sales Pty Ltd
50 Evans Street, Sunbury

* Pay/release rental bonds to/from Rental Bond Authorities (where applicable)
* Refer to Tribunals, Courts and Statutory Authorities (where necessary)
* Refer to Collection Agents/Lawyers (where default / enforcement action is required)
* Provide confirmation details for organisations contacting us on your behalf. Example: Banks, Utilities (Gas Electricity, Water, Phone), Employers etc.

If your personal information is not provided to us, and you do not consent to the uses to which we put your personal information, we cannot properly assess the risk to our client, or carry out our duties as professional property managers. Consequently, we then cannot provide you with the lease / tenancy of the premises.

Ntd DISCLOSURE STATEMENT
You can contact National Tenancy Database Pty Ltd (ABN 65 079 105 025) (“ntd”) by :
Telephone: (03) 9610 4996
Fax: (03) 9620 7339
By Post: P.O. Box 156, Collins Street West, Vic 8007
In Person: Level 7, 477 Collins Street, Melbourne
Website: www.ntd.net.au

From 21st December 2001, you can gain access to your personal information.

PRIMARY PURPOSE
ntd collects your personal information to provide to its members and others listed below, historical tenancy and public record information on individuals and companies who/which lease residential and commercial property from or through licensed estate agent members of ntd.

ntd also provides credit information on companies/directors applying for commercial leases.

The real estate agent / property manager will advise ntd of your conduct throughout the lease / tenancy, and that information will form part of your tenant history.

Ntd usually discloses information to:
* Licensed real estate agent members
* Ntd’s parent company, Collection House Limited ABN 74 010 230 716 and its subsidiaries and related entities
* Credit Bureaus

If your personal information is not provided to ntd, the real estate agent / property manager will not be able to carry out their professional responsibilities and will not be able to provide you with a lease/tenancy of the premises.

Privacy Statement - Top