12 Vellum Loop

Tenancy Details

Rent per week

Required tenancy period (months)

Tenancy required from

Tenancy required to

Total number of adults

Total number of children

Ages of all children

Do you have any pets?

Pet 1

Type of pet

Breed

Registration No.

Age

Pet 2

Type of pet

Breed

Registration No.

Age

Do you intend on applying for a residential tenancy bond from a State Government Department?

Bond amount

Branch

Bank account details

For refund of Option Fee (if applicable)

Bank

BSB

Bank account

Account name

Any special conditions requested by you NOTE: The Lessor is not obliged to accept any of your Special Conditions.

Address details

The address at which you wish to receive the Residential Tenancy Agreement if you are successful and/or notices relating to tenancy

Email (optional)

Fax (optional)

PO Box

Town / City

Postcode

Address