Tenancy
Bond lodgement form
All sections of this form must be completed to enable smooth processing of information, payment and future refunds
Landlords’ and all tenants’ signatures must be provided. Incomplete forms will be returned
Complete in a black or blue pen with CAPITAL leers if handwriting
Read the important information on the back of this form before entering any details
1
If payment is to an existing bond for this tenancy, enter the bond number here:
Use the
Additional tenants bond lodgement form
if more than
2 tenants. Attach it to this form.
Yes, this form is attached.
3a
Landlord details
Are you a first time landlord?
Yes
Landlord ID:
Full name(s) or trading name
Contact phone
3b
Landlord address for service Email will be first point of contact if provided
Email
Unit
House no.
Street
Suburb
City
PO Box or
Private Bag
Postcode
Landlord Signatures
Date
D D M M Y Y
By signing this form you agree that the
infor mation you have provided is true and correct
2
Address of the rented property Property ID (if known):
Room no.
(for boarding house
or room only tenancy)
Unit
House no.
Street
Suburb
City
Building name
Postcode
Weekly rent
Total bond
Total amount enclosed
Date tenancy started
D D M M Y Y
Dwelling type (tick one):
See reverse for definitions
House/Townhouse Apartment Room
Boarding house room Bedsit/Flat
No. of
bedrooms
4a
Tenant 1 details
Full name
Bond contribution
Are you a first time tenant? Yes
Date of Birth
D D M M Y Y
Contact phone
(optional)
4b
Tenant 1 new address for service Email will be first point of contact if provided
Email
Room no.
(for boarding house
or room only tenancy)
Unit
House no.
Street
Suburb
City
PO Box or
Private Bag
Postcode
Signature
Date
D D M M Y Y
By signing this form you agree that the
information you have provided is true and correct
4c
Tenant 2 details
Full name
Bond contribution
Are you a first time tenant? Yes
Date of Birth
D D M M Y Y
Contact phone
(optional)
4d
Tenant 2 new address for service Email will be first point of contact if provided
Email
Room no.
(for boarding house
or room only tenancy)
Unit
House no.
Street
Suburb
City
PO Box or
Private Bag
Postcode
Signature
Date
D D M M Y Y
By signing this form you agree that the
information you have provided is true and correct
Tenancy
If you need to add more tenants, please use the
Additional tenants bond lodgement form
and aach it to this form.
Privacy statement
Information provided on this
form will be held and used by the
Ministry of Business, Innovation and
Employment for the purposes of
enforcing and administering the
Residential Tenancies Act 1986.
It may also be used for carrying out
customer surveys, public education
and statistical analysis, and we may
occasionally provide your information
to third parties to carry out this work
on our behalf.
We collect date of birth information
to help us ensure that we can
correctly identify you. Supplying
your date of birth is optional.
Bond contribution information
provided to Tenancy Services may be
used to help confirm refund details
for each tenant at the end of the
tenancy. Supplying this information
is optional.
The personal information you supply
will not be used for any other reasons
unless permied under the Privacy
Act 1993 (e.g. with your consent or
for a directly related purpose). The
information may also be provided
to third parties where it is required
or permied by law. The personal
information you supply will be
provided to all parties named on
this form or on the bond record. You
can access or correct your personal
information held by us at any time.
Dwelling type definitions
House/Townhouse: When you live
in a self-contained property, usually
a building with land
Apartment: When you live in a
property with self-contained areas
(e.g. apartments, units) and shared
areas (e.g. building lis, driveways)
Boarding House Room: When you
live in a room in a boarding house
– i.e. rented separately but sharing
facilities in a building intended for
6 people or more
Room: When you live in a room in a
house which is not a boarding house
– i.e. rented separately but sharing
facilities in a building intended for
less than 6 people
Bedsit/Flat: When you live in a place
which is either part of a subdivided
building, or a building which is
independent of the primary residence
of a property (e.g. sleep-out)
Property ID number
If you do not know the Property
ID number for this property, leave
the box blank.
Weekly rent and Dwelling type
This information is gathered by
Tenancy Services so that the general
public and landlords have access to
current rental market information
through the Tenancy Services
website. No personal, individual
bond or property information will
be published there.
No. of bedrooms – If you are only
renting a room, the number of
bedrooms is one.
Landlord ID number
If you do not know the Landlord ID
number, leave the box blank.
Address for service
This information will assist Tenancy
Services to contact you regarding this
bond and to minimise any delays in
paying out/refunding the bond when
the tenancy finishes.
Landlord’s address for service:
If you provide an email address, we
will use this as the primary means for
communication. However, a physical
address must also be provided.
If we need to contact you at a street
address regarding this tenancy we
will use the address for service you
provided.
In addition to a street address,
a PO Box address can also be
provided as an address for service.
Tenant’s address for service:
If you provide an email address, we
will use this as the primary means for
communication. If we need to contact
you at a street address during your
tenancy we will use the address of
the rented property or the address
fo
r service you give us. A new address
for service is required aer the
tenancy has ended.
In addition to a street address,
a PO Box can also be provided to
be used as an address for service.
PLEASE NOTE: By providing a PO Box
or email address, you are authorising
Tenancy Services to use these to
contact yo
u.
Any questions?
All our forms and other information
are on our website at
www.tenancy.govt.nz
If you have any questions about
this form or need more information
about bonds, please Freephone
0800 737 666 or contact us by email
at www.tenancy.govt.nz/contact-us
Ki te mea he pātai āu mō tēnei puka,
kei te pīrangi pārongo rānei mō te
moni here (bond), waea koreutu
0800 737 666, whakapā rānei ki a
mātou i te īmēra www.tenancy.govt.
nz/contact-us
A iai ni fesili e uiga i lenei pepa pe
mana’omia fo’i nisi fa’amatalaga
e uiga i le tupe fa’amau (bond),
fa’amolemole telefoni mai i le numera
0800 737 666, pe feso’ota’i mai ile
emeli www.tenancy.govt.nz/
contact-us
若您有任何关于表格方面的疑问, 或是
希望获得 有关押金的更多详情, 请拨打我
们的免费热线电话 0800 737 666, 或发
送电邮至以下网站内的相应电邮 地址,
我们联系: www.tenancy.govt.nz/
contact-us
If you have questions about your
rights and obligations when renting
call our tenancy information line
Freephone: 0800 TENANCY
(0800 83 62 62)
Send us your form
Online: If paying online, please go to
www.tenancy.govt.nz and follow the
‘Lodging a bond’ online instructions.
Post: If paying by cheque please send
this form and cheque to: Tenancy
Services, PO Box 50 445, Porirua 5240.
Please make the cheque payable to:
Tenancy Services
MBIE 3639 T1 (05/18)
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