Guarantor

Referencing Application Form

IAL
Bairstow Eves(Nottingham) [email protected]

Scheme No. 1517130 Telephone 01159501400

To avoid any unnecessary delays, please complete in full, in BLACK INK using BLOCK CAPITAL LETTERS.. Incomplete forms will be returned.
Once completed, you can enter this application online via connect.homelet.co.uk for an instant acknowledgement.

1 TENANT DETAILS [To be completed by the Letting Agent]

Please let us know who the Guarantor is standing for

NT
Applicant 1
Reference Applicant’s
Number Surname

Applicant 2
Reference Applicant’s
Number Surname
Please complete Section 2
IDE
2 PROPERTY TO LET [To be completed by the Letting Agent]
Property Address

Postcode Total rent per calendar month

How much will the Guarantor Cover?

Applicant 1 share of rent PCM Applicant 2 share of rent PCM

Included in
How is Rent Guarantee offered to your landlord? Free of charge Separate charge Management Fee N/A

Property Let Type Let Only Managed Rent Collect

NF

No. of bedrooms

Property type Detached Semi detached Flat Terraced Bungalow

When was the property built?

(eg 1984)

Tenancy term (months) Tenancy start date / /

Is the tenant paying the full rent in advance? Yes No If yes, do you require HomeLet to obtain financial references? Yes No
CO

Please complete Section 3

Confidentiality note: The information contained within this application is being transmitted and is intended only for HomeLet. If the reader of this message is not the intended recipient, you are hereby advised
that any dissemination, distribution or copying of this application is strictly prohibited. If you receive this application in error please notify us immediately by calling 0845 111 2222.
 Guarantor
Referencing Application Form

IAL
Scheme No. 1517130 Telephone 01159501400

3 YOUR PERSONAL DETAILS [To be completed by the Guarantor]

Title: Mr x Mrs Miss Other

First name Nicolae Middle name

Last name Covacs

Email [email protected]

NT
Other names Date of birth 18 / 01 / 1982
Your Your
Telephone Mobile 07459201701

Employment status Employed x Self-employed Retired Independent means On contract

Total gross annual income 28600

Bank / building society details: please provide the details of your current account
IDE
Account holder(s) Nicolae Covacs Bank name

Bank Account no. Sort code

IMPORTANT - ADVERSE CREDIT HISTORY

Do you have any County Court Judgements, Court Decrees, Bankruptcy, Administration Orders, NO YES
Individual Voluntary Arrangements, or any other adverse credit history whether settled or not?
If YES, please detail on a separate sheet. Please note that failure to disclose information relating to adverse credit history may result in your application being declined.

4 YOUR ADDRESS [To be completed by the Guarantor]

NF

Current
Address 261B Denman Street

Nottingham Postcode NG7 3FQ

Period at Address 3 Years 8 Months

We require three years worth of your address history. If you have lived at this address for more than three years,
please move to section 5. If you have been there for less than three years, please provide your previous address(es) below.
Previous
Address 25 Hazelwood Road
CO

Nottingham Postcode NG7 5LA

Period at Address 4 Years 11 Months

Address

Postcode

Period at Address Years Months

Please complete section 5

Confidentiality note: The information contained within this application is being transmitted and is intended only for HomeLet. If the reader of this message is not the intended recipient, you are hereby advised
that any dissemination, distribution or copying of this application is strictly prohibited. If you receive this application in error please notify us immediately by calling 0845 111 2222.
 Guarantor
Referencing Application Form

IAL
Scheme No. 1517130 Telephone 01159501400

5 YOUR FINANCIAL INFORMATION [To be completed by the Guarantor]

Please tell us about your earnings and provide the details of a financial referee below (please tick one). Failure to provide your gross annual income
will prevent us from contacting your referee and will delay your application.
Current Employer x Pension Administrator Accountant Self-employed (SA302 / SA100)

Company
Name Pork Farms

Address Queens Drive Industrial Estate,

NT
Nottingham Postcode NG2 1LW
Contact Contact
Name Debora Bolton Position Managing Director

Telephone 01159435717 Fax

Email Providing an email address or fax number could result in a QUICKER

RESPONSE from your referee.

Your position Line Production

Is this position: Permanent x Contract Contract Terms Months Hours per week
IDE
Payroll/Service/Pension number: Q80479

Gross Salary/Pension/Drawings per annum: If self-employed please indicate your

28.600
earnings from the last year

Start Date 10/05/2018 End Date (if applicable)

Do you have a second job, or additional pension? IF YES, please enter the details in section 6
Will your employment change before the proposed tenancy starts? IF YES, please go to section 6
IF NO, please go to section 7

6 ADDITIONAL FINANCIAL INFORMATION [To be completed by the Guarantor]

If you are changing to new employment, have a second job or another source of income, please provide details in this section.
Future employer Second employer Pension administrator Accountant Benefit/other
NF

Company
Name

Contact
Address

Postcode

Contact Contact
Name Position

Telephone Fax

Email Providing an email address or fax number could result in a QUICKER RE-
SPONSE from your referee.
CO

Your Position

Is this position: Permanent Contract Contract Terms Months Hours per week

Payroll/Service/Pension number:

Gross Salary/Pension/Drawings per annum: If self-employed please include your

earnings from the last year

Start Date End Date (if applicable)

Confidentiality note: The information contained within this application is being transmitted and is intended only for HomeLet. If the reader of this message is not the intended recipient, you are hereby advised
that any dissemination, distribution or copying of this application is strictly prohibited. If you receive this application in error please notify us immediately by calling 0845 111 2222.
 Guarantor
Referencing Application Form

Scheme No. 1517130 Telephone 01159501400

7 ABOUT YOUR REFERENCE [To be completed by the Guarantor]

By completing this form, you have agreed to act as Guarantor for the tenant named within this form. The tenant’s reference will be completed by HomeLet on
behalf of their letting agent. HomeLet is part of the Barbon Insurance Group Limited and for the purposes of this application, Barbon is the Data Controller as
defined in the Data Protection Act 1998 (the “Act”).
In order to complete this application, HomeLet will consult with a number of sources to verify the information, including a licensed credit reference agency. As
a result of the information received:
■ HomeLet may pass on any information supplied to the landlord and/or letting agent, including the results of any linked verification checks.
■ By consulting with a credit reference agency, HomeLet will share your information with them and the agency may record the results of this search. This
search may show how you conduct payments with other organisations. From time to time, this information may also be used for debt tracing and fraud
prevention. You may request the name and address of the Credit Reference agency HomeLet use and you may also apply for a copy of the information
they provided to HomeLet.
■ If you default in respect of any covenants you have given as guarantor (including the payment of rent on behalf of the tenant when the tenant has failed
to pay their rent), HomeLet may record this on a centrally held database of defaulting debtors, and such a default could affect any future application for
tenancies, credit, and/or insurance.
■ HomeLet may use debt collection agencies or tracing agents to trace your whereabouts and recover any monies owed to HomeLet.
■ If false or inaccurate information is provided and fraud is identified, details will be passed to fraud prevention agencies to prevent fraud and money
laundering.

Information may be sent to you and your nominated referees by email. This information will only be sufficient enough to identify you and it won’t be excessive;
however you should be aware that information sent via electronic means can’t be guaranteed to be secure.

PLEASE READ AND COMPLETE THE FOLLOWING STATEMENTS CAREFULLY – IT’S IMPORTANT THAT YOU PROVIDE YOUR CONSENT FOR THE
CHECKS BY MARKING THE BOXES NEXT TO THE TEXT AND THEN SIGNING AND DATING BELOW.

I confirm that the information provided in this application form is true to the best of my knowledge, and I’m happy with the checks which
YES x
HomeLet will complete as detailed above. These results may be accessed again if I apply to act as a guarantor in the future.

I’m happy for HomeLet to contact my referees (including those outside the EEA), with personal information which has been provided
YES x
in this form to allow them to verify the information about my earnings, dates of employment and previous tenancy term.

Please note, if you’d like to find out more about any of the information sources we access to complete your application,
please visit homelet.co.uk/ref-info.

Signed

Full name Nicolae Covacs Date 17/12/2023

Additional Information - To be completed by the Guarantor

HL2157 12/14

HomeLet is a trading name of Barbon Insurance Group Limited which is authorised and regulated by the Financial Conduct Authority for insurance mediation. Registered in England number 3135797. Registered office ad-
dress: Hestia House, Edgewest Road, Lincoln, LN6 7EL

Confidentiality note: The information contained within this application is being transmitted and is intended only for HomeLet. If the reader of this message is not the intended recipient, you are hereby advised
that any dissemination, distribution or copying of this application is strictly prohibited. If you receive this application in error please notify us immediately by calling 0845 111 2222.