Application Form
APPLICATION FOR RESIDENTIAL TENANCY
AGENT FOR LESSOR Julie Nilsson
PROPERTY ADDRESS UNIT ……. Lu Elle Palms 1-9 Gray Street, Tweed Heads, 2485
Ph 07 55365033 Fax 07 55365044 Email luellepalms@hotmail.com
First Applicant: Full Name …………………………………………………………………Date of Birth……………………………..
Drivers Licence No. ………………….Ph. Hm………………..Wk………… ……..Mob……….………….Email……………………..
Second Applicant: Full Name……………………………………………………………….Date of Birth………………………………
Drivers Licence No. …………………..Ph. Hm………………..Wk….……………..Mob………..…………Email……………………
I/We agree to supply any of the following information to assist in the processing of this application and agree that the agent may photocopy any item and retain as part
of this application in accordance with Privacy Principle 1.3 of the Privacy Act.
This office is a member of TICA Default Tenancy Division Pty Ltd, and as such all applications for tenancy will be checked with TICA
First Applicant Second Applicant
1. Photo Identification – Passport or Drivers Licence YES NO YES NO
2. Minimum of TWO references from previous lessor or agent YES NO YES NO
3. Last FOUR rent receipts or copy of tenants payment ledger YES NO YES NO
4. Copy of previous accounts eg. Telstra, Electricity, Gas etc YES NO YES NO
5. Proof if Income (i.e. Pay slips, Work contract, Centrelink) YES NO YES NO
Full Names of all other persons who will occupy the Property – (show ages of all children)
(All Applicants other than those named in 1 & 2 must complete a separate Application form)
…………………………………………………………………………………………………………………………………………….
First Applicant Second Applicant
Have you ever been evicted by any lessor/agent? YES NO YES NO
Have you ever been refused another property by any lessor/agent? YES NO YES NO
Are you in debt to another lessor or agent? YES NO YES NO
Is there any reason known to you that would affect your rent payment? YES NO YES NO
Was your rental bond at your last address refunded in full? YES NO YES NO
If NO – What deductions were made? Rent Arrears $……………….. $…………………..
Repairs $……………….. $ ………………….
Cleaning $……………….. $ ………………….
FIRST APPLICANT
Present Address …………………………………………………………………………………. Phone ………………………………..
Period of Occupancy ………………………..Reason For Leaving ………………………………Rent paid $…………………………..
Name of Agent or Owner …………………………………………Phone……………………………Fax……………………………….
Previous Address ………………………………………………………………………………………………………………………….
Occupation …………………………………………………………………..Net Weekly Income $…………………………………….
Employer …………………………………………………………………….Period with current employer …………………………….
Phone ………………………..Fax…………………………..………. What day of each week/fortnight is your pay-day ………………..
If Self-Employed
Name of Business …………………………………….A.C.N. ……………………………………Industry ……………………………
Address ………………………………………………………………………How long self employed? ………………………………..
Name of Accountant ……………………………………………………………………………….Phone . …………………………….
Personal Referees (Do not include Relatives)
(1) Name & Address ………………………………………………………………………………Phone ………………………………
(2) Name & Address ………………………………………………………………………………Phone ………………………………
Name of Relatives or other persons to contact in case of emergency
(1) Name & Address ……………………………………………………..Relationship …………………………Phone ……………….
(2) Name & Address ……………………………………………………..Relationship …………………………Phone ……………….
SECOND APPLICANT
Present Address …………………………………………………………………………………. Phone ………………………………..
Period of Occupancy ………………………..Reason For Leaving …………………………… ..Rent paid $………………………….
Name of Agent or Owner ………………………………………………Phone…………………………Fax…………………………….
Previous Address ………………………………………………………………………………………………………………………….
Occupation …………………………………………………………………..Net Weekly Income $…………………………………….
Employer …………………………………………………………………….Period with current employer …………………………….
Phone ……………………………Fax……………………………… What day of each week/fortnight is your pay-day ………………..
If Self-Employed
Name of Business …………………………………….A.C.N. ……………………………………Industry ……………………………
Address ………………………………………………………………………How long self employed? ………………………………..
Name of Accountant ……………………………………………………………………………….Phone.…………………………….
Personal Referees (Do not include Relatives)
(1)Name & Address ……………………………………………………………………………….Phone ………………………………
(2)
(2)Name & Address ……………………………………………………………………………….Phone ………………………………
(3)
Name of Relatives or other persons to contact in case of emergency
(1)Name & Address …………………………………………………..Relationship …………………………Phone ……………….
(2)
(2)Name & Address …………………………………………………..Relationship …………………………Phone ……………….
(3)
Total Number of Vehicles to be kept at premises ……………………………………………………………………………………….
Car Registration #. …………………Model ……………………….Car Owned or Hire Purchase/Company………………………..
Car Registration #. …………………Model ……………………….Car Owned or Hire Purchase/Company ……………………….
PETS ARE NOT PERMITTED ON THE PREMISES WITHOUT BODY CORPORATE APROVAL
1. I/We, the Applicant(s) declare that the above information is true and correct and that I/we have supplied it of our own free will AND I/we hereby
authorise you as the letting agent, to conduct any enquiries, and/or searches, including any tenancy information databases in order to verify the above
information in accordance with Privacy Principle 1.3 of the Privacy Act.
2. I/We acknowledge that any false information I/we provide in this application could jeopardise this application and any
subsequent tenancy agreement I/we enter into on approval by the lessor or agent.
3. I/We acknowledge and accept that if this application is rejected, the agent is not legally obliged to give reasons for the rejection.
4. I/We, the Applicant/s declare that I/we am/are not bankrupt and that the rental is within my/our means.
5. I/We have inspected the premises and wish to take a tenancy for the period of ……………………. from / / at a
Rental of $ ……………….per week. I/we also undertake to pay a Rental Bond of $ …………………when I/we sign the Tenancy
Agreement.
6. It is agreed that immediately upon communication of acceptance of this application by the lessors agent, that the tenant will pay a
non-refundable deposit equal to two weeks rent within 24 hours.
Date / /
First Applicant/s Signature ………………………………………………………. Contact No…………………………………………
In the presence of (signature) …………………………………………………….
Date / /
Second Applicant/s Signature ………………………………………………………. Contact No………………………………………
In the presence of (signature) …………………………………………………….
Date / /
OFFICE USE ONLY:
Privacy Act Acknowledgement Form for Tenant Applicants & Approved Occupants
This form provides information about how we the below named agent handle your personal information, as required by the National
Privacy Principles in the Privacy Act 1988, and seeks your consent to disclosures to TICA Default Tenancy Control Pty Ltd (TICA) in
specified circumstances. If you do not consent to the disclosure of your personal information to TICA we can not process your
application.
Member Name: Lu Elle Palms Letting Service
Address: 87/1-9 Gray Street TWEED HEADS 2485
Ph: 07 5536 5033 Fax: 07 5536 5044
Email: luellepalms@hotmail.com
As a professional asset manager we collect personal information about you. The information we collect can be accessed by you by
contacting our office on the above numbers or addresses.
Primary Purpose
Before a tenancy accepted we collect your information to assess the risk to our clients in providing you with a property you have
requested to rent and if considered acceptable provide you with a tenancy for the property.
In order to assess your application we disclose your personal information to
· The Lessor / Owners for approval or rejection of your application
· TICA Default Tenancy Control Pty Ltd to assess the risk to our clients and verify the details provided in your tenancy
application.
· Referees to validate information supplied in your application
· Other Real Estate Agents to assess the risk to our clients
Secondary Purpose
During and after the tenancy we may need to disclose your personal information to
· Tradespeople to contact you for repairs and maintenance of the property.
· Refer to Tribunals or Courts having jurisdiction seeking orders or remedies.
· Refer to Debt Collection Agencies where Tribunal / Court orders have been awarded.
· Refer to TICA Default Tenancy Control Pty Ltd to record details of your tenancy history.
· Refer to the Lessors / Owners insurer in the event of an insurance claim.
· To provide future rental references to other asset managers / owners.
If you fail to provide your personal information and do not consent to the uses set out above we cannot properly assess the risk to our
client or carry out our duties as an asset manager. Consequently we cannot provide you with the property you requested to rent.
TICA Statement
As TICA may collect personal information about you, the following information about TICA is provided in accordance with the
National Privacy Principles in the Privacy Act 1988.
TICA Default Tenancy Control Pty Ltd (ABN 84 087 400 379) is a tenancy database that records tenants personal information from
its members including tenancy application inquiries and tenancy history. In accordance with the National Privacy Principles you are
entitled to have access to any personal information that we may hold on any of our databases. To obtain your information from TICA
Default Tenancy Control Pty Ltd proof of identity will be required and can be made by any of the following ways
Phone: 190 222 0346 calls are charged at $ 4.50 per minute including GST (higher from mobile or pay phone)
Mail: TICA Public Inquiries PO BOX 120, CONCORD NSW 2137 a fee of $ 8.80 plus stamped self addressed envelope is
required.
Primary Purpose
TICA collects information from its members on tenancy related matters and provides such information to other members as a risk
management system for the purpose of assessing a tenancy application. TICA does not provide any information that it collects to any
other individual or organisation for any other purpose other than assessing a tenancy application or risk management system other than
government departments and or agencies allowed by law to obtain information from TICA.
The personal information that TICA may hold is as follows
Name, date of birth, drivers license number, proof of age card number and or passport number (except Australian), comments made by
a TICA member in relation to your tenancy, which members you rented through and which members you applied to.
Further Information about TICA
Full details about TICA can be found on TICA’s website at www.tica.com.au under Tenant Information and Privacy Policies or by
contacting TICA on our Helpline 190 222 0346 calls charged at $ 4.50 per minute including GST (higher from mobile and pay
phones)
If your personal information is not provided to TICA the member may not proceed with assessing your application and you may not
be provided with the rental property.
Signed By the Applicant/s
Signature Print Name
Signature Print Name
/ /
Date Day Month Year Witnessed
Lu Elle Palms Rental Tweed Heads
Welcome to Rental Tweed Heads at Lu Elle Palms on the Northern Rivers and Gold Coast doorstep. Less than 5 minutes to Tweed Heads Shopping Centre
Handy to Twin Towns and local Greenmount and Rainbow Bay surf beaches.
Banora and Coolangatta golf courses nearby.
Well suited to retirees looking for a secure place to rent.
Please call to check for availabilty.
Modern Apartments For Rent
Air conditioned two and three bedroom apartments.
Limited number of two level apartments with street access.
Set at the end of a no through street.
Video intercom and key card access.
Secure undercover parking.
Visitors parking within the grounds.
Solar heated lap pool, wading pool, children’s fenced play area , gym and recreation room.
Resident Managers.

Open Plan Design
Open plan air conditioned carpeted living area.
Tiled dining area with sliding glass door opening onto a private balcony or porch.
Individual colour schemes with matching vertical drapes
Solid concrete slabs reduce noise between the apartment levels.
Modern Kitchen
With Lu Elle Palms Rental Tweed Heads you get generous size tiled kitchen with wide benches, microwave hutch, pantry and plenty of cupboard space.
The kitchen is equipped with a stainless steel wall oven, ceran cooktop, dishwasher, twin sinks, garbage disposal unit and flick mixer tap.
The split level apartments have a tiled open plan living and dining area with direct internal access from the garage and a sliding glass door opening onto a private balcony.
Bathroom & Bedrooms
The tiled two way bathroom has a clear glass shower recess and separate bath.
All bedrooms have built in wardrobes with shelves.
Gardens & Grounds
Central courtyard areas feature raised beds with tropical gardens.
25m solar heated inground salt water lap pool.
Other
Separate laundry with clothes dryer.
Flyscreens throughout.
Wired for cable television.
Generous size tiled kitchen with wide benches, microwave hutch, pantry and plenty of cupboard space.
Individual lock up garages within the locked basement carpark.
Tenancy Conditions.
Rent per week:
Two bedroom two bathroom from $285
Villas and townhouses from $350
Bond: 4 weeks rent
Duration of lease: 6 to 12 months
References required
Click here for a tenancy application lu elle palms pdf form.
Contact Details
Phone:+61 7 55365033
Fax:+61 7 5536 5044
Mobile Intl:+61 0488 585 135
Mobile Local: 0488 585 135
E-mail: rentals@luellepalms.com.au
1- 9 Gray St Tweed Heads NSW 2485
For further information or to arrange an inspection please contact Tweed Heads Lu Elle Palms Resident Manager Julie Nilsson at Lu Elle Palms

