Application – Hereford Lettings

Applicant 1: First name *

Applicant 1: Surname *

Applicant 1: Telephone number *

Applicant 1: Email address *

Applicant 1: Full address and postcode *

Applicant 1: How long have you lived at this address? * Enter number of years & months

Applicant 1: Are you currently renting? *

Yes
No

•Applicant 1: If you are renting what is your Landlord or Letting Agents full name?

Applicant 1: Employment status *

Employed full-time
Employed part-time
Self-employed
Unemployed
Retired

Applicant 1: Name of employer * Or business if self-employed

Applicant 1: Monthly income * Enter the amount of take home pay received each month

Applicant 1: Monthly benefits received * Used for affordability only

None
Housing Benefit
Universal Credit
Child Benefit
Tax Credits
Disability Benefit
Other

Applicant 1: Other benefit details *

Applicant 1: Total amount of benefits received each month Enter the total amount of all benefits received

Applicant 1: Are you aware of any reason why you might not pass referencing? ? * This includes any County Court Judgments, IVAs, bankruptcy, or unpaid rent or debts. Please note that a referencing check will be carried out, and we would rather discuss any concerns with you at the start than at a later stage

No
Yes

Applicant 1: if you answered Yes, please briefly explain.

Are you applying for a joint tenancy with another adult? *

Yes
No, myself only

Applicant 2: First name *

Applicant 2: Surname *

Applicant 2: Telephone number *

Applicant 2: Email address *

Applicant 2: Full address and postcode *

Applicant 2: How long have you lived at this address? Enter the number of years & months

Applicant 2: Are you currently renting? *

Yes
No

Applicant 2: If you are renting what is your Landlord or Letting Agents full name?

Applicant 2: Employment status *

Employed full-time
Employed part-time
Self-employed
Unemployed
Retired

Applicant 2: Name of employer * Or business if self-employed

Applicant 2: Monthly income * Enter the amount of your monthly take-home pay

Applicant 2: Benefits received *

None
Housing Benefit
Universal Credit
Child Benefit
Tax Credits
Disability Benefit
Other

Applicant 2: Other benefit details *

Applicant 2: Total amount of benefits received each month Enter the total of all benefits received each month

Applicant 2 - Are you aware of any reason why you might not pass referencing? This includes any County Court Judgments, IVAs, bankruptcy, or unpaid rent or debts. Please note that a referencing check will be carried out, and we would rather discuss any concerns with you at the start than at a later stage

No
Yes

Applicant 2: if you answered Yes, please briefly explain.

Number of adults & children living with you? *

Please provide age for every child under 18 *

Do you or does anyone else in your household smoke? *

Yes
No

Do you have any pets? *

Yes
No

Please provide details of all your pets * Species, breed and number, for the landlord consideration

Preferred move-in date Enter the earliest date

• How they heard about the property

Hereford Lettings Website
Facebook
Friend / Family
Other

• Tick to confirm the information is accurate and that a holding deposit may be retained only in the circumstances the Tenant Fees Act 2019 lists

Consent for storing submitted data *

Yes, I give permission to store and process my data

Application form