Tenant Application Form – Express Let & Sales

Emergency Contact (must be independent UK resident, not joint applicant)*
First Last
Relationship*
Email*
Address*
Street Address Address Line 2 Town / City County Post Code
Telephone Daytime
Mobile Phone Number*
Consent to Contact*
- I consent to the agent contacting the above named person in the event of an emergency or if a situation requires urgent attention.

Name of Employer (Company Name)*
Address of employer*
Street Address Address Line 2 County Town/City Post Code
Your job/title or description*
Telephone No*
Name of your work supervisor or someone we may contact for an employment reference*
Email*
Date of Employment From*
Annual Salary*
Are your employment circumstances likely to change in the period of the tenancy/the next year? (whichever is shorter) If so, how?

Other Income

If you are in receipt of any other forms of income, please detail them below. If these do not apply, you can simply skip this page by clicking 'next' at the bottom.
Are you claiming Housing Benefit / Local Housing Allowance?*
Housing Benefit (Monthly)
Monthly State Pension
Monthly Private Pension
Working Tax Credit (Monthly)
Income Support (Monthly)
Disability Allowance / PIP (Monthly)
Other Income (Monthly)

12.1. I am applying for a tenancy on the basis that the property or accommodation will be my main or only home.
12.2. I give permission for enquiries to be made based on the information i have provided to establish my status, which includes immigration status under the Right to Rent Act 2014. We will carry out these checks on your behalf.
12.3. I also certify that i do not
- have any County Court Judgements against me
- owe money to any Housing Benefit Department or any Local Authority
- owe monies or dilapidation monies to any previous Landlord
- have substance or alcohol abuse problems
Signature*
You must sign to confirm your acceptance of our terms
Date*
Date Format: DD dash MM dash YYYY
IF YOU KNOWINGLY SUPPLY FALSE INFORMATION IT MAY BE USED BY LANDLORD TO SEEK POSSESSION OF THE PROPERTY UNDER GROUNF 17 OF SECTION 8 OF THE HOUSING ACT 1998 ( AS AMENDED BY SECTION 102 OF THE HOUSING ACT 1996). The information on this form is for the sole use of the landlord only for the purposes of letting. No information contained therein will be divulged to any third party, unless the tenant defaults.

Other Income