Application Form - Newton Fallowell Forms

Your Information

Title

First names (required)

Middle names

Surname (required)

Calling name (if different from above)

Previous name (i.e. maiden name)

Home telephone

Mobile telephone

Work telephone

Preferred contact telephone (required)

Personal email

Work email

Preferred contact email (required)

Economic status (required)

National insurance number

Passport number

Housing benefit reference number

Retired gross annual income

Student number

Adverse credit history

Marital status

Date of birth (required)

Country of birth

Are you a smoker?

Do you have pets?

If you do have pets, please add details here

Higher Education

University/College (required)

House name/number

Street

Street continued

Area

Town

County

Postcode

Country

Dependents

Dependent One

First names

Surname

Relationship

Date of birth

Dependent Two

First names

Surname

Relationship

Date of birth

Dependent Three

First names

Surname

Relationship

Date of birth

Dependent Four

First names

Surname

Relationship

Date of birth

Dependent Five

First names

Surname

Relationship

Date of birth

Addresses

Please provide 3 years worth of address history. Enter your current address and then your previous addresses starting from most recently occupied.

Current Address

House name/number (required)

Street

Street continued

Area

Town

County

Country

Postcode

Approximate move in date (required)

Add Additional Address

Please provide the best address to reach you at after the tenancy. For example: a known future address, a work address or a relative's address.

Post Tenancy Address

House name/number

Street

Street continued

Area

Town

County

Country

Postcode

Guarantor (where required)

If you can supply a UK guarantor who meets the specified criteria please fill in the fields below

Does the guarantor have a UK bank account

Guarantor first names

Guarantor last name

Guarantor home telephone number

Guarantor mobile telephone number

Guarantor work telephone number

Guarantor email address

Guarantor address

House number

Street

Street (continued)

Area

Town

County

Country

Postcode

Years at address

Months at address

References - Education

Education reference

University/College

Student number

Period

Telephone

Identification number

House name/number

Street

Street continued

Area

Town

County

Country

Postcode

References - Landlords

Current landlord reference

Name

Telephone

Managing agent

Start date

End date

House name/number (for Landlord)

Street (for Landlord)

Street continued (for Landlord)

Area (for Landlord)

Town (for Landlord)

County (for Landlord)

Country (for Landlord)

Postcode (for Landlord)

References - Additional

Additional reference

Name

Telephone

Relationship

Years known

End date

House name/number

Street

Street continued

Area

Town

County

Country

Postcode

Additional reference

Name

Telephone

Relationship

Years known

End date

House name/number

Street

Street continued

Area

Town

County

Country

Postcode

Additional reference

Name

Telephone

Relationship

Years known

End date

House name/number

Street

Street continued

Area

Town

County

Country

Postcode

Employment History

Current Employer

Company name (required)

Contact name (required)

Email address

Telephone (required)

Length of employment (years) (required)

Job title (required)

Salary (£/per annum)(required)

Date started (required)

House name/number

Street

Street continued

Area

Town

County

Country

Postcode

Permanent

Full time

Previous Employer 1

Company name

Contact name

Email address

Telephone

Length of employment (years)

Job Title

Salary (£/per annum)

Date started

Date ended

House name/number

Street

Street continued

Area

Town

County

Country

Postcode

Permanent

Full time

Previous Employer 2

Company name

Contact name

Email address

Telephone

Length of employment (years)

Job Title

Salary (£/per annum)

Date started

Date ended

House name/number

Street

Street continued

Area

Town

County

Country

Postcode

Permanent

Full time

As part of the legal process of letting a property we may be required to provide you with certain information (e.g. the How to Rent guide) prescribed by law. Please confirm if we may email you this information and other documents and notices to reduce our environmental impact through unnecessary printing.

I understand that by submitting this form I consent to the collection, use and disclosure of my personal information by the Landlord and/or their agent in order to obtain references and to check my creditworthiness for the leasing of the property, for advising utilities companies of a change of occupier or for making such other use of the personal information as the Landlord and/or their agent deems appropriate. I confirm that all information provided above is correct. I hereby authorise the verification of the information contained in this application and information obtained from personal references.

Rent details

Higher Education

Emergency Contact

Dependents

Dependent One

Dependent Two

Dependent Three

Dependent Four

Dependent Five

Addresses

Current Address

Post Tenancy Address

Guarantor address

Education reference

Current landlord reference

Additional reference

Additional reference

Additional reference

Employment History

Current Employer

Previous Employer 1

Previous Employer 2