Personal details

Title *

Forename *

Middle name

Surname *

Date of birth *

National Insurance number *

Marital status *

Number of children/dependants *

Mobile phone number *

Email address *

Gross annual salary/income *

Current address & postcode *

Time at current address *

Status at current address *

Owner with mortgage

Owner with no mortgage

Tenant

Living with family

Living with friends

Other (use Additional Info area to explain)

Previous address & postcode *

Time at previous address *

Next of kin name *

Next of kin relationship to you *

Next of kin address *

Next of kin phone number *

Other Occupiers

Name any joint tenants or other adult occupiers and their relationship to you *

Name & address of person paying the deposit *

Employment/occupation details

Current employment status *

Employed

Self employed

Unemployed

Retired

Other (please explain in the Additional Info area below)

Bank details

Bank account holder name

Bank account number

Bank sort code

Existing financial commitments

Do you have any loans or overdrafts? Please give details here *

Do you have any credit/store cards? Please give details here *

Have you, your spouse or any other party to this application been insolvent, bankrupt, made arrangements with creditors or been involved in any criminal or civil court proceedings in the last six years? *

Yes

No

Please give details of any criminal convictions, insolvency or bankruptcy *

Additional Information *

Please use this area to add any other information that you think might be useful or to give more details about a previous question.

Consent declaration

I confirm that the information contained in this application is true to the best of my knowledge and belief and may be verified.
I agree that Portsmouth Lettings or their agent/s may search the files of one or more Credit Referencing Agencies and that the results of these findings may be forwarded to the appointed Letting Agent or Landlord.
I also understand that in the event of failing to make a rental payment a default maybe recorded against my credit file.
I understand that should any of the information contained in this application be found to be untrue the application will be declined and I may lose all or part of the administration fee.
I give my employer, accountant and current landlord/letting agent permission to disclose any information requested by Portsmouth Lettings or their agent/s.
I agree that by ticking the box below I am signing this form and accept the legal responsibility of doing so.

Tick this box to sign this form & to confirm that you have read, understood & acknowledged the above *

Yes