HUNTER REGION NILS CONFIRMATION OF BOARD OR PRIVATE RENT

A Statutory Declaration is usually provided to confirm board or private rent. However, due to current COVID-19 restrictions this form can be used to confirm these expenses.

Please complete this form if you pay board or private rent directly to your landlord, home owner or lease holder (not to a real estate agent, or public housing agency).

Date

I *Please provide your full name.

currently live at - (please include Unit/Street Number & Name) *

Suburb or Town *

State *

Postcode *

I have lived at this address for *

My current board/rental payment is: *

per *

*Please tick all expenses covered in your current rent or board payment.

Additional Information:Use the space above to include any details that may help explain your current situation.

If you are happy for us to confirm your board or rental payments, please provide contact details for your housemate or private landlord below:

First Name

Last Name

Phone

Email

Details of your previous address:

If you have lived in your current address for 0-3 mths, please provide your previous address below

Time at previous address

Please don't hestate to contact us if you need any help.