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DATA PROTECTION ACT 1998 Name Address DECLARATION Salford Home Search may have to telephone or contact agencies and organizations to make enquiries to support any information that you may have given. In accordance with the requirements of the Data Protection Act 1998 I have hereby agreed that information held by any of the organisations listed below may be made available to Salford Home Search Salford City Council in support of my application for accommodation. SIGNATURE DATE. /. NATIONAL INSURANCE NUMBER The above named applicant has applied to Salford Home Search for re-housing. Each applicant must provide a satisfactory rent reference from their current landlord before any applicant will be allowed to bid for properties. Rent Reference Applicant Please ask your current / former landlord to complete this side of the form about your rent account. If your landlord requires permission for your information to be disclosed please use the reverse side of this form* Ref no NAME OF APPLICANT DATE OF BIRTH /. I would therefore be grateful if you could complete the information below. Please sign and date the form and mark with your official stamp business card or headed paper. Current/ Previous Landlord Please provide any additional information not covered above that you feel is relevant Tenancy start date. /. /. Tenancy end date. /. /. if previous landlord Does the applicant owe any rent If yes how much Have you received any payments from these arrears How often have you received payments Weekly / Monthly / other. behaviour Is/ Was the property kept in good condition Comments Contact name Signed. Date Telephone number and Address. Yes/ No COMPANY STAMP Salford Housing Options Point Salford Opportunities Centre 2 Paddington Close Salford M6 5PL Telephone 0161 793 2020 your present / previous rent account. Rent Reference Applicant Please ask your current / former landlord to complete this side of the form about your rent account. If your landlord requires permission for your information to be disclosed please use the reverse side of this form* Ref no NAME OF APPLICANT DATE OF BIRTH /. I would therefore be grateful if you could complete the information below. Please sign and date the form and mark with your official stamp business card or headed paper. Current/ Previous Landlord Please provide any additional information not covered above that you feel is relevant Tenancy start date. Current/ Previous Landlord Please provide any additional information not covered above that you feel is relevant Tenancy start date. /. /. Tenancy end date. /. /. if previous landlord Does the applicant owe any rent If yes how much Have you received any payments from these arrears How often have you received payments Weekly / Monthly / other. /. /. Tenancy end date. /. /. if previous landlord Does the applicant owe any rent If yes how much Have you received any payments from these arrears How often have you received payments Weekly / Monthly / other. behaviour Is/ Was the property kept in good condition Comments Contact name Signed. Date Telephone number and Address.

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