E-Application Form

Upstix E-Application Form
Preferred tenancy length *
What is your expected residency status? *

Applicant Details

Applicant Details
Current Residential Status *
Will any pets live at the property *
Do you have any County Court Judgements, court decrees, bankruptcy, administration orders, IVAs or any other adverse credit history whether settled or not *
Do you smoke? *

Current and previous address history

Please provide address history to cover the last 3 years

Living status *

Previous Address (If Applicable)

Living status

2nd Previous Address (If Applicable)

Living status *

Current Letting agent/ Landlord/ Managing Agent (if applicable)

We cannot accept references from relatives or friends

Please note all referencing is carried out by email so please ensure an email address is provided
Have you ever been served a late rent notice *
Have you ever been served an eviction notice *

Financial information

Is this position
If self employed please give accountant details.
Please note all referencing is carried by email so please ensure an email address is provided

Other income (if applicable)

Please provide details of any additional income such as benefits received, additional employment or future
employment if your employment is due to change before the start of the tenancy.

Please attach copies of award letters, pay slips, P60, savings accounts etc to show additional income

Please note all referencing is carried by email so please ensure an email address is provided

Bank Details

Next of Kin

Documents Required With This Form

We cannot proceed with your application without these documents

Please provide proof of identity such as passport, national identity card or driving licence.

We also require your last 3 months’ bank statements for your current bank account. N.B. You may be required to provide a copy of a Police Check as part of our reference enquiries.

Maximum upload size: 2MB

I hereby confirm that the information provided by me is to the best of my knowledge true, accurate and complete. I
understand that the information that I have submitted will be used in order to assess my suitability to be granted a
tenancy agreement, or to be named on the tenancy agreement as a Guarantor. I also understand that it will be used
to verify my identity to prevent and detect fraud and money laundering, collections and recoveries, and I give my
consent to the information that I have provided being shared with third parties for this purpose.

I understand and agree that current or former employers, landlords and letting agents may be asked to provide
additional information about me or to verify information that I have provided.

I further agree that the information that I have provided will be submitted to Ittria in order that a credit
check can be conducted. I acknowledge that Upstix is not entitled to disclose a copy of my credit report to me but
that I may obtain a copy of the report by applying to the relevant credit reference agency directly. I understand that
I may be refused a tenancy, or may be found unsuitable to act as a Guarantor as a result of the searches and
references obtained by Upstix and I agree that I shall not seek to hold Upstix liable for such refusal nor shall I seek to
bring any claim against Upstix for any loss or damage suffered by me as a result of such refusal. I understand that
information which I provide or which is collected about me may be retained on file or stored electronically in
accordance with the provisions of the Data Protection Act 1998.

I understand that acceptance of this form does not constitute an offer of a tenancy and that once the landlord is
willing to proceed with full referencing I will be required to pay a holding deposit equivalent to 1 one weeks rent. I
understand that this holding deposit is only effective for 15 days and that it will not be refunded if I withdraw my
application during this time, give false information on this form which would affect the tenancy, fail the Right to Rent
check or if I fail to take all reasonable steps to enter into a tenancy agreement within the 15 day time frame.

I hereby authorise

My employer / accountant / pension administrator to provide details of my earnings and dates of employment to Upstix *
My current/previous landlords and letting agents to confirm details of previous tenancies to Upstix *
A credit check to be carried out by Equifax *
My details being passed to Rent4sure for the purpose of advising utility companies and Local Authority *
Should my application be successful I agree that the holding deposit will go towards the first months rent *