Application Form

1. Property

Address you are applying for:

2. Personal Details

This email address will be used as an address for service (strike out if not agreed).

Do you smoke?
If under 18 years of age, are you married?
Have you ever had an Order made against you by the tenancy tribunal?

NOTE: A copy of your ID must be supplied with your application.

If you are a New Zealand or Australian citizen:


If you are NOT a New Zealand or Australian citizen:


3. Application Details

Who will be living with you at the property? (All other adults will need to complete their own Application Form)

Person 1 (if applicable)

Person 2 (if applicable)

Person 3 (if applicable)


Will you be parking vehicles at the property? 

Car 1 (if applicable)

Car 2 (if applicable)

4. Income

What is your source of income?

Note: An employment reference will strengthen your application.

5. History

Current Address

Address Situation

We require three (3) years’ worth of your address history. If you have lived at this address for more than three (3) years, please move to section 6. If you have been there for less than three (3) years, please provide your previous address(es) below.

Address 1

Address Situation

Address 2

Address Situation

I consent to Housemart using the information provided here to complete a Credit Check to support my application. I consent to Housemart providing the information in this from and details of any proven breach of my tenancy agreement or of the Residential Tenancies Act 1986 to any credit bureau or tenant default database. I acknowledge that the information may then be publicly accessible through credit bureaux or tenant default databases. I agree that you may use any of the information on this form to enforce any judgement in respect of the tenancy agreement or in respect of any order against me made by the Tenancy Tribunal. I authorise the organisations and people detailed above to divulge any information Housemart may request. 

6. Contact

Physical address for service: Must be a physical address in New Zealand, where mail can be received on your behalf. E.g. family address, friends address, etc. 


Next of kin: A contact address of a family member or friend who does not live with you.

Address (if different from above)

7. Conditions

I understand this application is subject to the approval of the owner/agent. Upon acceptance of the application, I understand the property will not be secured until Housemart receive the first week’s rent as a deposit and that if I withdraw my application after this period, I will forfeit this payment. On acceptance of this application I also agree to enter in to a Tenancy Agreement to take the above residential premises for the agreed term and from the commencement date stated above.

We do not accept cash/cheques/eftpos in our office for payment of rent. All rent payments must be made by Automatic Payment only and this will be a condition of your Tenancy Agreement. Should this application be accepted, you will be required to provide your bank account details at the time of signing your lease, otherwise the tenancy will not proceed. No personal cheques are acceptable.

Confidentiality note: The information contained within this application is being transmitted and is intended only for Housemart. If the reader of this message is not the intended recipient, you are hereby advised that any dissemination, distribution or copying of this application is strictly prohibited. If you receive this application in error please notify us immediately by calling 03 442 3815.