Application Form
1. We are unable to process your application if you have County Court Judgements.
2. All applicants must complete this form in full. Contact the office if you have any queries.
3. A non-refundable administration fee of £180.00 is payable when you reserve a property, at which time the property is taken off the market whilst references are applied for. If there are more than two applicants for the property, a £75.00 is payable for each additional applicant.
4. A £75.00 non-refundable administration fee is payable if you have a pet.
5. We require proof of i.d. in the form of:- Sight of your passport or photographic driving licence, and copy of a utility bill from your current address.
6. If you are a visitor from a non EU country we require sight of your passport and work permit or entry permit.
7. We will process your application and contact you once all references have been received.
8. If you are accepted as a tenant the date will then be confirmed for the signing of the tenancy agreement.
9. On the date the agreement is signed you must pay one month's rent and the deposit, which is the equivalent of one and a half month's rent minimum. Both these amounts must be paid in cleared funds i.e. cash, bankers draft, debit card or credit card.
10. If paying by credit or debit card there will be an additional administration charge, which is made by the card companies. The charge is 2.2% for credit cards or £0.40 for debit cards. Please note that we do not accept American Express.
11. It is your responsibility to take out insurance to cover the landlord's contents, fixtures and fittings against tenant damage. A copy of the policy must be shown to the agent at the commencement of the tenancy.
12. If you are not aware of your legal requirements under the terms of the tenancy agreement and addendum (schedule of charges for tenants) please ask for draft copies before proceeding further.
13. All charges are inclusive of VAT.

PART A: To be completed by all applicants. (* required fields)

Address of property you wish to rent: *
What approximate date would you like to move into the property: *
How do you propose to pay the rent: * Own means Housing Benefit
Please give details of all adult tenants moving into the property
  First Name Middle Initial(s) Surname Shore of rent
Tenant 1: *
Tenant 2:
Tenant 3:
Tenant 4:

PART B: To be completed by all applicants.

Please complete all boxes. If more than one applicant, Parts B to D must be completed as appropriate for each.

Personal Details

Mr/Mrs/Miss/Ms: * Other Please Specify:
Surname: *
First Name: * Middle Initial(s):
Date of birth: * Sex: Male Female
Marital Status: Maiden Name:
Daytime: * Evening:
Mobile: Work: *
Email Address: *
Do you have any pets? * Yes No
If yes please specify, including the breed if you have a dog:
Are you a smoker? * Yes No
Please give us details of someone we can contact in the event of an emergency
Name: *
Address:
Telephone: * Mobile:
Names of children living in the property and their dates of birth: (if applicable)
1)
2)
3)
4)
Current Address
House Number/Name: (* or below)
Flat Number/Name: (* or above)
Street:
Town:
District:
County: Postcode: *
Status: * Owner Rented Living with parents Council
Other (Please specify):
Previous Address (complete only if you have lived at your current address for less than 3 years).
House Number/Name:
Flat Number/Name:
Street:
Town:
District:
County: Postcode:
Status: Owner Rented Living with parents Council
Other (Please specify):

PART C: To be completed by all applicants.

Employment Details (If applicable):
Employment Status: Employed Self Employed Unemployed Student Retired Payment In Advance
Profession:
Annual Income(gross): Employment Start Date:
Payroll/Pension Number:
Additional Income (If applicable):
Are your circumstances likely to change? Yes No
If yes please give further details:
If you have additional income, please advise how much per annum:
Source of additional income:
Employer Details:
If you are employed, self employed or retired, give details of your accountant or pension provider (alternatively you may provide proof of pension) below, and authorize them to reply to the enquiries which will be made to verify this information.
Please complete ALL boxes, including details for referee:
Employer/Accountant/Pension Provider:
Office/House Name:
Street Number/Name:
Town:
District:
County: Postcode:
Contact Name:
Contact Job Title:
Daytime Telephone No.(Please include STD code):
Mobile Telephone No.(Please include STD code):
Email Address:
Fax No.(Please include STD code):
Landlord Details (if applicable):
Landlord/Agent Name:
Complete this section if you indicated that you are or have lived in rented accommodation.
Please complete ALL boxes, including individual contact details (telephone and fax number) for landlord or current managing agent.
Office/House Name:
Street Number/Name:
Town:
District:
County: Postcode:
Daytime Telephone No.(Please include STD code):
Mobile Telephone No.(Please include STD code):
Email Address:
Fax No.(Please include STD code):

PART D: To be completed by all applicants.

Bank/Building Society Details:
Name of Bank: *
Address: *
Account in the name of: *
How long with this branch: *
Sort Code: * Account Number: *
Do you have a cheque guarantee card? Yes No
Applicant's consent:
The information which I have given in my Application form is correct 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 the resulting verified information will 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 Lumley Letsure Limited searching information held by a credit reference agency and agree that Lumley Letsure Limited 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. All such information that is revealed may be used by other lenders for the purpose of assessing 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 any forwarding address at the determination of any tenancy being passed to the landlord and/or to the utility companies and/or the local authority.
Otherwise all information will be treated as confidential.
I consent to the information contained in my Application form being used by Lumley Letsure Limited and other members of the Lumley Group and/or Agent to notify me of other products and services as appropriate. Please tick the box if you do not wish your information to be used by Lumley Letsure Limited and other members of the Lumley Group and/or Agent to notify you of other products and services.
I agree that the 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 held about me be amended if it is found to be incorrect.