Residential Rental Application (Statement of Information for Rental Applicants) — Residential Tenancies Act 1997 (Vic) s 29C; Residential Tenancies Regulations 2021 (Vic) reg 14 Instructions
This form contains 148 fields organized into 35 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Additional Sources of Income | ||
| Additional Source of Income Details | Text |
Please provide details about the additional source of income.
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| Additional Income Type | Text |
Specify the type of additional income.
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| Additional Monthly Income | Number |
Enter the monthly income received from this additional source.
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| Applicant Declaration | ||
| Declaration Items | Text |
Please provide any items you would like attended to prior to your tenancy if the property was not in clean condition.
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| Applicant Declaration Signed | Text |
Please provide the signature for this applicant declaration.
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| Applicant Declaration Name | Text |
Please provide the full name of the applicant for this declaration.
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| Applicant Declaration Date | Date |
Please provide the date when this applicant declaration was made.
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| Applicant Printed Name | Text |
Please provide the printed name of the applicant.
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| Applicant Name | ||
| Middle Name | Text |
Enter the applicant's middle name.
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| First Name | Text |
Enter the applicant's first name.
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| Surname | Text |
Enter the applicant's surname.
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| Contact Details | ||
| Text |
Please provide your email address.
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| Mobile Phone Number | Text |
Please provide your mobile phone number.
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| Work Phone Number | Text |
Please provide your work phone number.
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| Home Phone Number | Text |
Please provide your home phone number.
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| Current Address | ||
| Current Address Postcode | Text |
Please enter the postcode for the current address.
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| Current Address Line 1 | Text |
Please enter the current street address, including unit or apartment number if applicable.
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| Current Employer | ||
| Current Employer Company Name | Text |
Enter the name of your current employer company.
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| Current Employer Contact Person | Text |
Provide the name of the contact person at your current employer.
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| Current Employer Your Position | Text |
Enter your position or job title at your current employer.
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| Current Employer Employment Address | Text |
Enter the full address of your current employer.
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| Current Employer Postcode | Text |
Provide the postcode for your current employer's address.
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| Current Employer Phone No. | Text |
Enter the phone number of your current employer.
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| Current Employer Email | Text |
Provide the email address of your current employer.
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| Current Employer Net Income per Month | Number |
Enter your net income from your current employer per month.
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| Current Employer Employed Since | Date |
Enter the date you started employment with your current employer.
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| Current Home Owner Details | ||
| Selling/Leasing Agent Name | Text |
Enter the name of the selling or leasing agent for your current home.
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| Selling/Leasing Agent Contact Person | Text |
Enter the contact person for the selling or leasing agent.
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| Selling/Leasing Agent Work Phone Number | Text |
Enter the work phone number for the selling or leasing agent.
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| Selling/Leasing Agent Mobile Phone Number | Text |
Enter the mobile phone number for the selling or leasing agent.
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| Current Home Sale/Rental Amount | Number |
Enter the sale amount or rental amount of your current home.
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| Years Owned Current Home | Text |
Enter the number of years you have owned your current home.
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| Months Owned Current Home | Text |
Enter the number of months you have owned your current home.
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| Selling/Leasing Agent Name (Second) | Text |
Enter the name of a second selling or leasing agent for your current home, if applicable.
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| Selling/Leasing Agent Name (Third) | Text |
Enter the name of a third selling or leasing agent for your current home, if applicable.
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| Current Rental Provider Details | ||
| Current Rental Provider Contact Person/Agency | Text |
Enter the name of the contact person or agency for the current rental provider.
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| Current Rental Provider Work Phone Number | Text |
Enter the work phone number of the current rental provider.
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| Current Rental Provider Home Phone Number | Text |
Enter the home phone number of the current rental provider, if it's a private rental provider.
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| Current Rental Provider Mobile Phone Number | Text |
Enter the mobile phone number of the current rental provider.
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| Current Weekly Rental Amount | Number |
Enter the current weekly rental amount.
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| Current Rental Provider Email | Text |
Enter the email address of the current rental provider.
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| Length of Tenancy Months | Text |
Enter the number of months for the length of tenancy at the current property.
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| Reason for Moving | Text |
Provide the reason for moving from the current rental property.
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| Length of Tenancy Years | Text |
Enter the number of years for the length of tenancy at the current property.
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| Date Inspected | ||
| Date Inspected | Date |
Provide the date the property was inspected.
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| Driver's Licence Details | ||
| B. Car registration No. 1 | Text | |
| Driver's Licence Expiry Date | Date |
Please enter the expiry date of your driver's licence.
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| Driver's Licence State of Issue | Text |
Please enter the state where your driver's licence was issued.
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| Driver's Licence Number | Text |
Please enter your driver's licence number.
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| Emergency Contact | ||
| Emergency Contact Name | Text |
Enter the full name of the emergency contact person.
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| Emergency Contact Relationship | Text |
Enter the relationship of the emergency contact to you (e.g., friend, parent, sibling).
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| Emergency Contact Email | Text |
Enter the email address of the emergency contact.
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| Emergency Contact Phone Number | Text |
Enter the phone number of the emergency contact.
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| Emergency Contact Address | Text |
Enter the full street address of the emergency contact.
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| Emergency Contact Postcode | Text |
Enter the postcode or zip code for the emergency contact's address.
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| First Personal Reference | ||
| First Personal Reference Name | Text |
Please provide the full name of the first personal reference.
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| First Personal Reference Relationship | Text |
Please describe the relationship with the first personal reference.
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| First Personal Reference Phone Number | Text |
Please provide the phone number of the first personal reference.
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| First Professional Reference | ||
| First Professional Reference Name | Text |
Enter the full name of the first professional reference.
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| First Professional Reference Relationship | Text |
Provide the relationship of the first professional reference to you.
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| First Professional Reference Phone Number | Text |
Enter the phone number of the first professional reference.
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| Full Time Student Details | ||
| Course Name | Text |
Enter the full name of the course you are currently studying.
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| Campus | Text |
Enter the name of the campus where you are studying.
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| Campus Contact | Text |
Provide the name or department of a contact person at your campus.
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| Enrolment Number | Text |
Enter your unique enrolment number for the course.
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| General | ||
| 12. This home is to be: Sold | CheckBox | |
| 12. Home is to be Rented | Checkbox |
Check this box if your current home is intended to be rented out.
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| 12. Home is to be Retained | Checkbox |
Check this box if your current home is intended to be retained by you.
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| 15. Was your home Sold | Checkbox |
Check this box if your previous home was sold.
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| 15. Was your home Rented | Checkbox |
Check this box if your previous home was rented out.
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| 15. Was your home Retained | Checkbox |
Check this box if your previous home was retained by you.
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| Full Time | Checkbox |
Check this box if your current employment status is full-time.
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| Part Time | Checkbox |
Check this box if your current employment status is part-time.
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| Casual | Checkbox |
Check this box if your current employment status is casual.
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| Signature Field | Signature | |
| Internet | Checkbox |
Check this box if you first saw the property advertised on the Internet.
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| Local Real Estate Magazine | Checkbox |
Check this box if you first saw the property advertised in a local real estate magazine.
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| Our Rental List | Checkbox |
Check this box if you first saw the property advertised on our rental list.
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| The Age | Checkbox |
Check this box if you first saw the property advertised in 'The Age' newspaper.
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| Relocation Consultant | Checkbox |
Check this box if you first learned about the property through a relocation consultant.
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| Other | Checkbox |
Check this box if you first saw the property advertised through a means not listed above.
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| K. Your Porter: Signature | Signature | |
| Number of Occupants | ||
| Number of Children | Text |
Enter the total number of children who will occupy the property.
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| Number of Adults | Text |
Enter the total number of adults who will occupy the property.
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| Office | ||
| Office | Text |
Provide the name or identification of the relevant office.
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| Other Applicant Names Row 1 | ||
| Other Applicant 1 Name | Text |
Enter the full name of the first additional adult applicant.
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| Other Applicant 2 Name | Text |
Enter the full name of the second additional adult applicant.
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| Other Applicant Names Row 2 | ||
| B. Applicant 3 1 | Text | |
| B. Applicant 3 2 | Text | |
| Page 1 | ||
| Applicant Name | Text |
Please enter the full name of the primary applicant for the rental property.
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| Property Address | Text |
Please enter the full street address of the residential property you are applying to rent.
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| Passport Details | ||
| Passport Expiry Date | Date |
Provide the expiration date of the passport.
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| Passport Number | Text |
Enter the passport number.
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| Passport Country | Text |
Enter the country of issue for the passport.
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| Pet Information | ||
| Pet Type/Breed | Text |
Enter the type or breed of the pet(s) that will reside at the property.
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| Pet Location (Inside/Outside) | Text |
Specify whether the pet(s) will primarily be kept inside or outside the property.
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| Pet Age | Text |
Enter the age(s) of the pet(s) that will reside at the property.
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| Number of Pets | Text |
Enter the total number of pets that will reside at the property.
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| Pets Yes/No | Text |
Enter whether pets will be residing at the property (Yes/No).
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| Preferred Commencement Date | ||
| 2. Preferred Commencement Date Year | Number |
Enter the year of the preferred commencement date.
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| 2. Preferred Commencement Date Month | Number |
Enter the month of the preferred commencement date.
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| 2. Preferred Commencement Date Day | Number |
Enter the day of the preferred commencement date.
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| Previous Address | ||
| Previous Address Line 1 | Text |
Enter the first line of the previous address.
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| Previous Address Line 2 | Text |
Enter the second line of the previous address.
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| Previous Address Postcode | Text |
Enter the postcode of the previous address.
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| Previous Employer | ||
| Previous Employer Company Name | Text |
Please provide the name of the previous employer's company.
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| Previous Employer Contact Person | Text |
Please provide the name of the contact person for the previous employer.
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| Previous Employer Your Position | Text |
Please provide your position or title at the previous employer.
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| Previous Employer Phone Number | Text |
Please provide the phone number for the previous employer.
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| Previous Employer Email | Text |
Please provide the email address for the previous employer.
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| Previous Employer Employment Period | Text |
Please provide the duration or period of employment with the previous employer.
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| Previous Employer Net Income | Number |
Please provide your net income from the previous employer.
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| Previous Home Owner Details | ||
| 15. Previous Home Owner Agent Name | Text |
Please enter the name of the agent who handled the sale or leasing of the previous home.
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| 15. Previous Home Owner Sale Price / Rental Amount | Number |
Please provide the sale price or rental amount for the previous home.
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| 15. Previous Home Owner Agent Contact | Text |
Please provide the contact details for the agent who handled the sale or leasing of the previous home.
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| 15. Previous Home Owner Agent Phone Number | Text |
Please enter the phone number of the agent who handled the sale or leasing of the previous home.
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| 15. Previous Home Owner Reason for Moving | Text |
Please provide the reason for moving from your previous home.
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| 15. Previous Home Owner Length of Stay Months | Text |
Please provide the number of months you resided at the previous home, in addition to the years.
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| 15. Previous Home Owner Length of Stay Years | Text |
Please provide the number of years you resided at the previous home.
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| Previous Rental Provider/Agent Details | ||
| Previous Rental Provider Contact Person/Agency | Text |
Please enter the name of the contact person or agency for the previous rental provider.
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| Previous Rental Provider Work Phone No. | Text |
Please enter the work phone number of the previous rental provider or agent.
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| Previous Rental Provider Mobile No. | Text |
Please enter the mobile phone number of the previous rental provider or agent.
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| Previous Rental Provider Email | Text |
Please enter the email address of the previous rental provider or agent.
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| Previous Weekly Rental | Number |
Please enter the weekly rental amount for the previous property.
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| Previous Tenancy Length Years | Text |
Please enter the number of years for the length of the previous tenancy.
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| Previous Tenancy Length Months | Text |
Please enter the number of months for the length of the previous tenancy.
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| Previous Reason for Moving | Text |
Please provide the reason for moving from the previous rental property.
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| Rental Amount | ||
| 4. Rental Amount | Number |
Enter the desired rental amount per week.
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| Rental Property Preferences | ||
| Rental Property Preference 2 | Text |
Enter the address of your second preferred rental property.
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| Rental Property Preference 1 | Text |
Enter the address of your first preferred rental property.
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| Second Personal Reference | ||
| Second Personal Reference Name | Text |
Enter the full name of the second personal reference.
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| Second Personal Reference Relationship | Text |
Enter the relationship of the second personal reference to you.
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| Second Personal Reference Phone Number | Text |
Enter the phone number of the second personal reference.
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| Second Professional Reference | ||
| Second Professional Reference Name | Text |
Please provide the full name of the second professional reference.
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| Second Professional Reference Relationship | Text |
Please describe your relationship with the second professional reference.
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| Second Professional Reference Phone Number | Text |
Please provide the phone number for the second professional reference.
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| Self-Employment Details | ||
| Self-Employment Accountant's Name | Text |
Please enter the full name of the self-employed individual's accountant.
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| Self-Employment Accountant's Contact Number | Text |
Please enter the contact number for the self-employed individual's accountant.
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| Self-Employment Type of Business | Text |
Please enter the type or nature of the self-employed business.
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| Self-Employment ACN | Text |
Please enter the Australian Company Number (ACN) for the self-employed business.
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| Self-Employment Business Operated From Home | Combobox |
Indicate whether any part of the self-employed business will be operated from home by entering 'Yes' or 'No'.
Yes
No
|
| Term | ||
| Term in Months | Text |
Enter the number of months for the term.
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| Utility Connection Declaration | ||
| Declaration Date | Date |
Provide the date the declaration is signed.
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| Utility Connections | ||
| Electricity | Checkbox |
Check this box if you want YourPorter to connect your electricity service.
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| Telephone | Checkbox |
Check this box if you want YourPorter to connect your telephone service.
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| Gas | Checkbox |
Check this box if you want YourPorter to connect your gas service.
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| Pay TV | Checkbox |
Check this box if you want YourPorter to connect your Pay TV service.
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| Internet | Checkbox |
Check this box if you want YourPorter to connect your internet service.
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