Application Form - Trentdale Investments Ltd - Houses to Rent in Stoke-on-Trent

Property Address*

Section 1: Your details

NAME & CONTACTS

Type of Application*

Single
Joint

Name*

Title (Mr, Mrs, Ms, Dr etc) First name Surname or family name

You

Previous name/s (if applicable)

Title (Mr, Mrs, Ms, Dr etc) First name Surname or family name

You

Your relationship to joint applicant

Name*

Title (Mr, Mrs, Ms, Dr etc) First name Surname or family name

Joint Applicant

Previous name/s (if applicable)

Title (Mr, Mrs, Ms, Dr etc) First name Surname or family name

Joint Applicant

Daytime telephone*

You

Mobile telephone

You

Work telephone

You

Daytime telephone*

Joint Applicant

Mobile telephone

Joint Applicant

Work telephone

Joint Applicant

Email

You

Email

Joint Applicant

Present address*

Address Line 1 Address Line 2 Address Line 3 Address Line 4 Postcode

Time living at current address*

Please select which of the following best describes your current housing situation*

Council tenant
Housing association tenant
Private tenant
Owner occupier
Living with family / friends

You

Present Landlord*

Please provide the name, address and telephone number of your current landlord, agent or housing association. We will contact them for a reference.

Please tick here if the joint applicant has a different address

Present address of joint applicant*

Address Line 1 Address Line 2 Address Line 3 Address Line 4 Postcode

Joint Applicant

Joint applicant's time living at current address*

Please select which of the following best describes the joint applicant's current housing situation*

Council tenant
Housing association tenant
Private tenant
Owner occupier
Living with family / friends

Joint Applicant

Present Landlord of the joint applicant*

Please provide the name, address and telephone number of the joint applicant's current landlord, agent or housing association. We will contact them for a reference.

May we contact your present landlord/s for references?*

Present Rent

Rent interval

Section 1: continued

PERSONAL DETAILS

Date of Birth*

You

Gender*

You

National Insurance number*

You

Date of Birth*

Joint Applicant

Gender*

Joint Applicant

National Insurance number*

Joint Applicant

Section 2: People who will live with you

OTHER PEOPLE

Please select how many people (including children) will live you (excluding joint applicant if applicable)*

Person 1: Name*

Relationship*

Date of Birth*

Employment status*

Person 2: Name*

Relationship*

Date of Birth*

Employment status*

Person 3: Name*

Relationship*

Date of Birth*

Employment status*

Person 4: Name*

Relationship*

Date of Birth*

Employment status*

Do you have any pets?*

Yes
No

Number and type of pet(s)*

Section 3: Your previous addresses

How many previous addresses have you had in the last 5 years?*

Previous address no. 1*

Address Line 1 Address Line 2 Address Line 3 Address Line 4 Postcode

Date moved in*

Date moved out*

Please select which of the following best describes your housing situation at this address*

Council tenant
Housing association tenant
Private tenant
Owner occupier
Living with family / friends

Reason for moving*

Landlord at previous address no.1*

Please provide the name, address and telephone number of the landlord, agent or housing association.

Previous address no. 2*

Address Line 1 Address Line 2 Address Line 3 Address Line 4 Postcode

Date moved in*

Date moved out*

Please select which of the following best describes your housing situation at this address*

Council tenant
Housing association tenant
Private tenant
Owner occupier
Living with family / friends

Reason for moving*

Landlord at previous address no.2*

Please provide the name, address and telephone number of the landlord, agent or housing association.

Please list any further previous addresses here*

Please include the name, address and telephone number of the relevant landlord, agent or housing association with each address

How many previous addresses has the joint applicant had in the last 5 years?*

Previous address no. 1*

Address Line 1 Address Line 2 Address Line 3 Address Line 4 Postcode

Joint Applicant

Date moved in*

Date moved out*

Please select which of the following best describes the joint applicant's housing situation at this address*

Council tenant
Housing association tenant
Private tenant
Owner occupier
Living with family / friends

Reason for moving

Landlord at previous address no.1*

Joint Applicant
Please provide the name, address and telephone number of the landlord, agent or housing association.

Previous address no. 2*

Address Line 1 Address Line 2 Address Line 3 Address Line 4 Postcode

Joint Applicant

Date moved in*

Date moved out*

Please select which of the following best describes the joint applicant's housing situation at this address*

Council tenant
Housing association tenant
Private tenant
Owner occupier
Living with family / friends

Reason for moving

Landlord at previous address no.2*

Joint Applicant
Please provide the name, address and telephone number of the landlord, agent or housing association.

Please list any further previous addresses here*

Please include the name, address and telephone number of the relevant landlord, agent or housing association with each address

Section 4: Employment and income

Do you have a bank account?*

Yes
No

Please be aware that we cannot offer you a home without a bank account.

Occupation*

Employer's name, address and telephone number*

May we contact your employer for references?*

Please state your annual income here*

Occupation*

Joint Applicant

Employer's name, address and telephone number*

Joint Applicant

May we contact the joint applicant's employer for references?*

Please state the joint applicant's annual income here*

Section 5: Benefits

BENEFIT DETAILS: Please state the amount you receive for each benefit listed below

Is your household entitled to Housing Benefit?*

You: the main applicant

Jobseekers' Allowance

Income Support

Child Benefit

State Pension

Pension Credit

Working Tax Credit

Carer's Allowance

ESA

DLA Care

DLA Mobility

Please state the amount received for each benefit listed below for the joint applicant

Jobseekers' Allowance

Income Support

Child Benefit

State Pension

Pension Credit

Working Tax Credit

Carer's Allowance

ESA

DLA Care

DLA Mobility

Other (please state name of benefit & value):

Section 6: Why you want to move

Please tell us why you want to move.*

Tell us if you are homeless or about to be made homeless. Also state any medical or job-related reasons for moving and anything else you feel is important. If you are moving to Staffordshire from another area, please give names and addresses of relatives you want to move near to if applicable.

Please tell us which area you would prefer to live in.

Section 7: Our lettings policy

We aim to create sustainable tenancies and stable communities. Because of this, we have an exclusion policy which enables us to exclude households from our register if:

proven evidence exists that they have a history of significant non-payment of rent or significant housing debt with any local authority or housing association;
they have a history of nuisance, violence or anti-social behaviour; or
they have been convicted of certain criminal offences

We will inform you if we exclude you from our register and you will have the right to appeal.

Have you or anyone in your household been involved in any type of behaviour that can be classed as anti-social or nuisance behaviour in the last 5 years?*

Yes
No

If yes, please give details*

Have you or anyone in your household been convicted of a crime?*

Yes
No

Offence*

Date of conviction*

Sentence received*

Sentence served*

Have you or anyone in your household ever been in trouble with the police in any other capacity, e.g. caution?*

Yes
No

If yes, please give details*

Have you or anyone in your householdever been made bankrupt or had any court orders made against you?*

Yes
No

If yes, please give details*

Any other relevant information which you think may help your application

Section 8: Documents required

You must provide original documents - not photocopies - to prove that you are eligible to rent a property in the UK. You must bring them to us yourself at our head office at Champagne House, 94 Corporation Street, Stoke on Trent ST4 4AY, or speak to us to make other arrangements. If you do not do this you will not be offered a home.
What you need to bring:

Your passport
Your National Identification card
Your residence card
Your current immigration status documents provided by the Home Office

If you cannot supply the above, you must bring two of the following:

A full birth certificate or adoption certificate issued in the UK
A current full or provisional UK driving licence
Original benefit paperwork issued by HMRC, the local authority or JobCentrePlus on behalf of the Department of Work and Pensions
Your current immigration status documents provided by the Home Office

Section 9: Data protection

By submitting this application form you are giving Trentdale Investments Ltd permission to store personal and sensitive data about you on our computerised housing register. The information you have given on this form will be stored on our computer system. Our staff will use it when they are letting homes.
You are allowed to inspect the information we hold about you on our computer system. We may charge a reasonable fee for this (not exceeding the maximum fee from time to time set down by Parliament).
This information is supplied to you to comply with the provisions of the Data Protection Act 1984 as amended from time to time.

Section 10: Declaration

I/we hereby certify that the details on this form are correct and i/we will notify Trentdale Investments Ltd if my/our circumstances change.
I/we understand that any false or misleading statement or witholding any relevant information now or later might lead to me/our application being cancelled or any tenancy granted to me/us being ended.
i/we hereby authorise any person or body to disclose to Trentdale Investments Ltd any information it requires, including financial details.

I understand that my landlord or any other authorised agent may submit or receive information about myself, and any person(s) who legally and properly share the accommodation which either intend to or currently reside. This information will only go to those authorised by the North Staffordshire Landlords Association Limited, acting within the principles of the Data Protection Act 1998.
I further understand that I may, at any time, upon payment of a statutory fee (not exceeding £10), request in writing from the database administrator a copy of the details held on me, the data subject.
False information knowingly supplied for the purposes of gaining a tenancy may render the tenant/applicant liable to damages for all losses and expenses incurred.

To signify you have read and agree with the conditions above, please click this box.*

I have read and agree with the conditions above

Please click here to view our privacy policy

To signify that you have read, understood and consent to the use and storage of your data outlined in our privacy policy, please click this box.*

I have read and understood the privacy policy

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