Rental Application Form
Property applied for:
Flat 4, 12 Orchard Road, Bristol BS3 4RT
Landlord or agent: Greenfield Lettings
Monthly rent: GBP 1,150
Wanted move-in date: 1 March 2027
Please fill in every part that applies to you. Completing this form does not create a tenancy. The landlord will decide after the checks below and will tell you the result.
1. Applicant
Full name: Maria Santos
Date of birth: 14 June 1991
Email: maria.santos@example.com
Phone: +44 7700 900456
2. Where you have lived
| Current address | Previous address | |
|---|---|---|
| Address | 27 Elm Grove, Bath BA1 2PQ | 8 Quay Lane, Cardiff CF10 4AB |
| From and to | June 2022 to now | August 2019 to June 2022 |
| Landlord and phone | Mr J. Kerr, 07700 900111 | Cardiff Homes, 029 5550 8899 |
| Rent paid | GBP 950 a month | GBP 800 a month |
Reason for moving: To be closer to my new job
3. Work and income
Employer or source of income, and job title: Bristol Health Trust, nurse
Since: September 2021
Income per month, before tax: GBP 3,400
Other income per month: GBP 200 from tutoring
The landlord may ask for proof of income, such as recent payslips, a contract or bank statements, only from the applicant it is going to choose.
4. References
- Alan Pike, line manager, alan.pike@example.com
- Mr J. Kerr, current landlord, 07700 900111
Do not name a relative as a reference. A reference may be a current or past landlord, an employer or a teacher.
5. Who will live in the property
Maria Santos, 35
Daniel Santos, 37
Lucia Santos, 6
Pets: One cat, aged 4, neutered
6. Consent to checks
I agree that the landlord or its agent may contact my references and my past and current landlords, and may check that what I have written here is true. With my further written agreement, it may also run a check on my identity, my right to rent and my credit history, as the law allows, and I understand that I may refuse and that the landlord may then decide not to go on with my application. I understand that a fee for a check is only charged if the law allows it, and that I will be told of it before it is charged.
7. How your information is used
Greenfield Lettings will use the information on this form only to decide whether to offer you the property, to carry out the checks above, and, if you are chosen, to prepare the tenancy. It will keep it safe, will share it only with the people who need it for those purposes, such as its agent and the referees you name, and will not sell it. It will keep this form for this long: 6 months after a decision if the application is refused, or for the length of the tenancy and the period the law requires if it is accepted. After that it will delete or destroy it.
You may ask to see what is held about you, to correct it, or to have it deleted, and you may ask the landlord to explain how a decision was made, using the contact details of the landlord or agent. You may complain to the data protection authority of your country. Ask to see the full privacy notice of the landlord if you would like more detail.
8. Declaration
I declare that the information I have given is true and complete to the best of my knowledge. I understand that false or missing information may lead to my application being refused, or, if I am already a tenant, to the tenancy being ended as the law allows.
Applicant: Maria Santos
Signature: ______________
Date: 7 November 2026
For the landlord's use
Received on: ______________
Checks done: ______________
Decision: ______________
Decision given to the applicant on: ______________