SmartRent application form Your application for Atrium Point 1 Moving in Where did you hear about the development? * Please select Advertising/signs at the site Network Homes website Newspaper or magazine Online adverts Search engine e.g. Google Share to buy website Word of mouth Other Where did you hear about the development? Is this a joint application? Yes No 2 About you - applicant 1 Title Mr Mrs Miss Ms Other First name * Middle name Last name * Date of birth * Date of birth shadow Address - house or flat number * Building Street * Town * County Postcode * London Borough * Email address * Mobile number * 2 About you - applicant 2 Title Mr Mrs Miss Ms Other First name * Middle name Last name * Date of birth * Date of birth shadow Address - house or flat number * Building Street * Town * County Postcode * London Borough * 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 * 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 * Start date shadow End date * End date shadow 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 * Start date shadow End date * End date shadow 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 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? If applicable, when does your leave to remain (visa) in the UK end? shadow 5 Residency - applicant 2 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? If applicable, when does your leave to remain (visa) in the UK end? shadow 6 Your current home - applicant 1 Are you renting privately? Yes No If yes, 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 If yes, please give full details * Do you own property in the UK or overseas? Please select Yes 6 Your current home - applicant 2 Are you renting privately? Yes No If yes, 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 If yes, please give full details * Do you own property in the UK or overseas? Please select Yes No 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 * Do you need wheelchair access? Yes No Aside from the applicants, will there be another person in the household? (This includes if you have children) Yes No 7b Your household - Additional Person 1 Surname * First name * Date of birth * Date of birth shadow Will there be another person in the household? Yes No 7c Your household - Additional Person 2 Surname * First name * Relationship to applicant Please select Partner Son Daughter Other Date of birth * Date of birth shadow 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 Date of birth * Date of birth shadow 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 Date of birth * Date of birth shadow 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. 8 Declaration of interest - applicant 2 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. 9. Disability - applicant 1 Do you consider you or a member of your house to be disabled? Yes No Maybe Are you a member or a member of your household a wheelchair user? Yes No 9 Disability - applicant 2 Are you or a member of your household registered disabled? Yes No Are you a member or a member of your household a wheelchair user? Yes No 10 Confirmation 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.
