Application Form
Dorset Register
of Accredited Landlords
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Application Form
Dorset Register of Accredited Landlords
Please ll in your details in BLOCK CAPITALS
Name:
Company name: (if applicable)
Address for correspondence:
Tel: Mobile:
E-mail address:
Name & address of Agent: (if applicable)
I am an Accredited Landlord with the:
National Landlord Association Accreditation Scheme
Residential Landlord Association Accreditation Scheme
National Landlord Accreditation Scheme
Date accreditation commenced:
Dorset Register
of Accredited Landlords
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Please provide details below of each of your properties which are occupied or available for
use in the private rental sector within the areas of Bournemouth, Poole, Christchurch, East
Dorset or Purbeck Councils.
Please list the properties located in each Council area in separate sections, indicating in which
Council area the properties are located.
This is to include Houses in Multiple Occupation (HMOs) and properties which are occupied by
single households.
Address Postcode
No.
storeys
No.
occupants
HMO
(y/n)
Council
Area
Please complete a separate sheet if necessary.
Dorset Register
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By signing up to the ‘Register’ you agree for your name to be published on the relevant Council
websites as a landlord who is accredited with one of the landlord accreditation organisations
recognised by the Dorset Register of Accredited Landlords.
DECLARATION
I am accredited with one of the three landlord accreditation bodies which are recognised by the
Dorset Register of Accredited Landlords.
The property details provided by me are correct and include all the relevant properties. I agree
to supply to the Council the details of any additional properties which I acquire within the
relevant areas whilst included on the Register.
I have read and understand the terms and conditions of the Register.
Signed:
Date:
DATA PROTECTION ACT 1998
Your name, contact details and a list of the properties owned or managed by you,
within the boundaries of each of the Councils signed up to this scheme, are required
for the purpose of the Register. This information will be shared with the Councils
signed up to the Dorset Register and also with the Landlord Accreditation Body with
which you are accredited.
For the purpose of investigating any complaint made about you in relation to your
responsibility as a landlord, your details and the details of the complaint will be
passed between the relevant landlord accreditation body and Council carrying out the
investigation or vice versa from the Council to the landlord accreditation body.
Information you provide on this form may also be disclosed within the operating
Councils to other departments within those Councils.
If you would like more information about how we look after your personal
information and your rights under the Data Protection Act 1998 please go to the
Council’s website at: http://www.bournemouth.gov.uk/CouncilDemocracy/
ProvidingandProtectingInformation/Moreaboutthelegislation/DataProtectionAct.aspx
Jan2013
Dorset Register
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