London Living Rent Application Form Your application for London Living Rent 1 Moving in Which development are you interested in? * A+ at The Assembly, Houslow Millharbour, Isle of Dogs The Madison, Canary Wharf Le Bon Court, Harrow Samuelson House, Southall Is this a joint application? Yes No What London Borough do you live in? If you live outside London please state none. * Please select City of London Barking and Dagenham Barnet Bexley Brent Bromley Camden Croydon Ealing Enfield Greenwich Hackney Hammersmith and Fulham Haringey Harrow Havering Hillingdon Hounslow Islington Kensington and Chelsea Kingston upon Thames Lambeth Lewisham Merton Newham Redbridge Richmond upon Thames Southwark Sutton Tower Hamlets Waltham Forest Wandsworth Westminster None What London Borough do you work in? If you work outside London please state none. * Please select Brent Barking and Dagenham Bexley Bromley Barnet Camden City of London Croydon Ealing Enfield Greenwich Hackney Hammersmith and Fulham Haringey Harrow Havering Hillingdon Hounslow Islington Kensington and Chelsea Kingston upon Thames Lambeth Lewisham Merton Newham Redbridge Richmond upon Thames Southwark Sutton Tower Hamlets Waltham Forest Wandsworth Westminster What is your total gross household income? * What is your total amount of household savings? * Do you, or anyone planning on living in the property smoke? * Please select Yes No 2 About you - applicant 1 Title Mr Mrs Miss Ms Other Title First name * Middle name Last name * Date of birth (DD/MM/YY) * Address - house or flat number * Building Street * Town * County Postcode * Email address * Mobile number * 2 About you - applicant 2 Title * Mr Mrs Ms Miss Dr First name * Middle name Last name * Date of birth (DD/MM/YY) * Address - house or flat number * Building Street * Town * County Postcode * Email address * Mobile number * 3 Do any of these statements apply to you? - applicant 1 Have you ever failed to keep up payments on a loan or any form of credit agreement? Yes No Do you have any unsatisfied County Court Judgements? Yes No Have you entered into an IVA - Individual Voluntary Credit Agreement? Yes No Have you been in arrears with your rent in the last 12 months? Yes No If yes, are you still in rent arrears? Yes No Have you been declared bankrupt within the last six years? Yes No 3 Do any of these statements apply to you? - applicant 2 Have you ever failed to keep up payments on a loan or any form of credit agreement? Yes No Do you have any unsatisfied County Court Judgements? Yes No Have you entered into an IVA - Individual Voluntary Credit Agreement? Yes No Have you been in arrears with your rent in the last 12 months? Yes No If yes, are you still in rent arrears? Yes No Have you been declared bankrupt within the last six years? Yes No 4 Your work - applicant 1 Job title/occupation * Employer's name, address and postcode * Address of your workplace if different from above How long have you worked in your current role? * Are you permanently employed? Yes No Are you employed on a fixed term or temporary contract? Yes No Start date * End date * What is your total (gross) annual salary? * If applicable, how much do you earn in bonuses and commissions per year? Are you self employed? Yes No Are you able to provide the SA302 tax calculation for the last financial year? Yes No 4 Your work - applicant 2 Job title/occupation * Employer's name, address and postcode * Employer's London Borough * Address of your workplace if different from above How long have you worked in your current role? * Are you permanently employed? Yes No Are you employed on a fixed term or temporary contract? Yes No Start date * End date * What is your total (gross) annual salary? * If applicable, how much do you earn in bonuses and commissions per year? Are you self employed? Yes No Are you able to provide the SA302 tax calculation for the last financial year? Yes No 5 Residency - applicant 1 Are you a British or EU or EEA citizen? Yes No If applicable, do you have indefinite leave to remain in the UK? Yes No If applicable, when does your leave to remain (visa) in the UK end? 5 Residency - applicant 2 Are you a British or EU or EEA citizen? Yes No If applicable, do you have indefinite leave to remain in the UK? Yes No If applicable, when does your leave to remain (visa) in the UK end? 6 Your current home - applicant 1 Are you renting privately? Yes No Please give contact name, address and phone number of your current landlord, housing association or council * Are you living with family or friends? Yes No Do you own property in the UK or overseas? Yes No If yes, please give full details * 6 Your current home - applicant 2 Are you renting privately? Yes No Please give contact name, address and phone number of your current landlord, housing association or council * Are you living with family or friends? Yes No Do you own property in the UK or overseas? Yes No If yes, please give full details * 7a Your household - only one applicant needs to fill out this section How many people in total, including children, will be living in the property? * Number of adults (18+) * Number of children * How many bedrooms will you need? Studio One bedroom Two bedrooms Three bedrooms Do you need wheelchair access? Yes No If yes, please give details of the pet * 7b Your household - Additional Person 1 Surname * First name * Relationship to applicant * Please select Partner Son Daughter Other Gender Male Female Date of birth * Will there be another person in the household? Yes No 7c Your household - Additional Person 2 Surname * First name * Relationship to the applicant * Please select Partner Son Daughter Other Gender Male Female Date of birth * Will there be another person in the household? Yes No 7d Your household - Additional Person 3 Surname * First name * Relationship to the applicant * Please select Partner Son Daughter Other Relationship to the applicant * Gender Male Female Date of birth * Will there be another person in the household? Yes No 7e Your household - Additional Person 4 Surname * First name * Relationship to the applicant * Please select Partner Son Daughter Other Gender Male Female Date of birth * 8 Declaration of interest - applicant 1 Network Homes is not normally permitted to grant benefits to its employees and Committee/Board members or other close relatives as prescribed by Schedule 1 of the Housing Act 1996. Are you or your partner related to anyone who is, or has been in the last 12 months, a member of Network Homes' Boards, Committees or Staff? Yes No If yes, please give full details * 10 Confirmation - applicant 1 Tick the box to confirm that all the information you have provided is true and correct I agree the information is true and correct Disclaimer Please note, once you submit your details, we will need to share your contact details and housing preferences with our partner Agent who looks after the development your interested in. Please see our Privacy Statement for information on how we process your personal data. Form not submitting? If this form will not submit please check you have completed all required sections. Any sections in red will need to be completed before the form can be submitted.