Real Estate/Lessor Tenancy Information Request
Please fill in the first section below and return to Horizon Housing Realty.
By doing so, you authorise Horizon Housing Realty to conduct a reference check from your current/previous real estate
agent or lessor, to allow processing of our Tenancy Application Form.
(If you have not leased a property before, you are not required to fill this form in)
Name of Applicant/s
Current Property Address
Signature/s Applicant 1 Applicant 2
Current/Previous Agent or Lessor Name
Email and Phone Number
IMPORTANT: This below section is to be completed by your current/previous real estate agent or lessor.
Horizon Housing will forward this form to them to complete.
CURRENT/PREVIOUS REAL ESTATE AGENT OR LESSOR
Please complete the following and return with a copy of the tenant's ledger to Fax (07) 5578 9522 or Email
admin@horizonhrl.com.au.
Is/was the above applicant a tenant at the address stated?
Yes No
What was the weekly rent?
$
Duration of Tenancy Mths/Yrs
Was the above applicant often in arrears?
Never Occa
sionally Always
Were there other tenants on the lease?
Yes No
Was the tenancy terminated by your office?
Yes No
If yes, reason why:
Were any “Form 11 - Notice to Remedy Breach” issued to the Tenant?
Yes No
If yes, reason why: How many?
Was a “Form 12 – Notice to Leave” issued?
Yes No
If yes, reason why:
Were periodic inspections carried out?
Yes No
Was the property/lawns kept in a neat & tidy condition
Yes No
If no, list problems:
Was the bond refunded in full? Or will it be?
Yes
No
If no, reason why
Were there pets kept at the property?
Yes No
If yes, how many & what type? Number: Type
Were the pets well kept?
Yes No
Would you recommend these applicants as good tenants
Yes No
Agent Name
Signature Phone
