NRAS Application No.

National Rental Affordability Scheme

Tenancy Application Form
This application form is intended for use by people applying to rent a property under the National Rental Affordability
Scheme.
The National Rental Affordability Scheme, an Australian Government initiative financially supported by the
Queensland Government, has delivered over 33,000 properties across Australia which are available for tenants at
affordable rents. Investors build new affordable housing and rents are set at least 20% below the market rent for the
properties. Ultimately, the tenancy manager will select the applicants who will be housed through the scheme.
Applying to rent a property through this scheme
Before applying for rental accommodation through this scheme, you should first check that you meet the eligibility
criteria as outlined in the National Rental Affordability Scheme – Information for prospective tenants in Queensland
fact sheet. You will also need to identify the property location/s that you wish to apply for. Further information about
available property locations can be found at National Rental Affordability Scheme Properties for Rent or by
telephoning 13 QGOV (13 7468) between 8:30am-4:30pm Monday to Friday.

To apply for the scheme, please:

 read all the questions carefully and complete this application form in full,
 have your signature witnessed by a Justice of the Peace or Commissioner for Declaration,
 attach all evidence of your household’s income (e.g. letter from your employer, Centrelink Income and Assets
Statement, Department of Veterans’ Affairs Income and Assets Statement, copy of Australian Taxation Office
Notice of Assessment for self employed people),
 attach all evidence of your household’s assets (e.g. Centrelink Income and Assets Statement, copies of bank,
building society or credit union statements showing money in accounts, statements from financial institutions
showing total sum of financial investments held in shares, bonds, debentures, friendly society bonds, property
trusts and any other trusts or managed investments, evidence detailing overseas pensions, compensation
payouts or lump sum payout documentation, written statement from superannuation company showing the
total amount in super fund or investment, including annuities (for applicants who have reached preservation
age),
 attach evidence of your Australian citizenship or permanent residency or bridging visa,
 attach copies of proof of identity documents for the applicant/s (i.e. driver’s licence, birth certificate, passport,
18+ Card, immigration papers or naturalisation or citizenship certificate), and
 send your completed application form and all attachments:
by email to [email protected] (preferred Method)
by mail to
Registration Officer
National Rental Affordability Scheme
Department of Communities, Housing and Digital Economy
GPO Box 690
Brisbane QLD 4001

When your application has been received, the department will assess your eligibility for the scheme and write to you
about the outcome of your application.

Important information
 You must be eligible for the National Rental Affordability Scheme at the time of this application and at the time of
being offered housing by the tenancy manager. You will be required to provide income evidence confirming that
you are still eligible for the scheme prior to being given a tenancy and upon annual review of your tenancy
circumstances.

 Lodgement of an application for the National Rental Affordability Scheme is not a guarantee that you will be
provided with housing. The individual tenancy managers of National Rental Affordability Scheme properties are
responsible for selecting the applicants who will be housed through the scheme.

www.chde.qld.gov.au 1 Version 1 - May 2022

1 What is your first language spoken at home?

Do you require a language interpreter for an interview or to discuss your application? Yes No

Do you require a signing interpreter for an interview or to discuss your application? Yes No

2 Do you need assistance when making decisions?

Is there a person who assists you to make decisions, or who makes decisions on your behalf in regard to personal, lifestyle, or financial
matters? This person might be a formally appointed guardian and/or an administrator or a family member, friend or advocate.

Yes No

If yes, please complete and attach one of these forms:

• PH005-1: ‘Formal Guardian and/or Administrator Details’, if you have a Guardian and/or Administrator formally appointed by
the Queensland Civil and Administrative Tribunal (QCAT), or
• PH005-2: ‘Informal Decision-maker Details’, if you have a family member, friend or advocate acting in the capacity of an
informal guardian and/or administrator.

3 What is your present address?

Postcode

Telephone (include area code) Private Business

Mobile Note - the department may also send you

information by SMS (text messages).

Email

Please indicate the way you would prefer the department contact you
(e.g. telephone, letter, SMS, email. Note - you can list more than one way)

You must advise us of any change to this address or your application may be cancelled.

Please provide the name of a relative, friend or organisation with a different address to you, whom the department could contact if
unable to contact you directly.

Person/organisation

Address

Postcode

Telephone (include area code) private/mobile Busines

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 Household member details

Please provide details of all the people to be housed. Please include all adults and children.

Household member 1 2 3 4

Surname

Title

First names

Date of birth
Male / Female /
Indeterminate/ Intersex /
Unspecified

Relationship to applicant Applicant

Centrelink’s Customer
Reference Number (CRN) or
Department of Veterans’
Affairs (DVA) Reference
Number

We are committed to improving housing outcomes for Indigenous people. The following information is
collected for reporting and planning purposes.

Please indicate if you are of: (Please tick  all boxes that apply.)
Aboriginal origin Yes No Yes No Yes No Yes No

Torres Strait Islander

origin Yes No Yes No Yes No Yes No

Australian South Sea

Islander origin Yes No Yes No Yes No Yes No

What is your residency status in Australia?

Australian citizen Yes No Yes No Yes No Yes No

Permanent resident Yes No Yes No Yes No Yes No

Temporary protection visa Yes No Yes No Yes No Yes No

Bridging visa due to the

expiry of your temporary Yes No Yes No Yes No Yes No
protection visa

Not a permanent resident Yes No Yes No Yes No Yes No

If there are more than four people in your household, please provide details for the additional household members below.

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Household member 5 6 7 8

Surname

Title

First names

Date of birth
Male / Female /
Indeterminate/ Intersex /
Unspecified

Relationship to applicant

Centrelink’s Customer
Reference Number (CRN) or
Department of Veterans’
Affairs (DVA) Reference
Number

We are committed to improving housing outcomes for Indigenous people. The following information is
collected for reporting and planning purposes.

Please indicate if you are of: (Please tick  all boxes that apply.)
Aboriginal origin Yes No Yes No Yes No Yes No

Torres Strait Islander

origin Yes No Yes No Yes No Yes No

Are you of Australian

South Sea Islander origin Yes No Yes No Yes No Yes No

What is your residency status in Australia?

Australian citizen Yes No Yes No Yes No Yes No

Permanent resident Yes No Yes No Yes No Yes No

Temporary protection visa Yes No Yes No Yes No Yes No

Bridging visa due to the

expiry of your temporary Yes No Yes No Yes No Yes No
protection visa

Not a permanent resident Yes No Yes No Yes No Yes No

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 Household income and asset information
Please provide details of the income and asset information for each household member.

Household member 1 2 3 4

Surname

First names

Income $ $ $ $ $

Income type (wages,

pension, allowance,
family payments)

Other income (for

example, maintenance,
superannuation, etc.)

Do you own or part own property either in Australia or overseas?

Residential (including a
house, flat, unit, Yes No Yes No Yes No Yes No
townhouse)
Vacant land (including
residential, commercial Yes No Yes No Yes No Yes No
or industrial, etc.)
Live-aboard boat,
caravan, mobile home
or transportable home Yes No Yes No Yes No Yes No
permanently connected
to utilities

Industrial property Yes No Yes No Yes No Yes No

Commercial property Yes No Yes No Yes No Yes No

If you answered yes to any of the above questions, please attach all documentation to the back page, and list below
the name/s of the person/s who owns the property and the address and details of the property ownership, including the
value of the property.

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 If there are more than four people in your household, please provide details for the additional household members below.

Household member 5 6 7 8

Surname

First names

Income $ $ $ $ $

Income type (wages,

pension, allowance, family
payments)

Other income (for example,

maintenance,
superannuation, etc.)

Do you own or part own property either in Australia or overseas?

Residential (including a
house, flat, unit, townhouse) Yes No Yes No Yes No Yes No

Vacant land (including

residential, commercial or Yes No Yes No Yes No Yes No
industrial, etc.)
Live-aboard boat, caravan,
mobile home or
transportable home Yes No Yes No Yes No Yes No
permanently connected to
utilities

Industrial property Yes No Yes No Yes No Yes No

Commercial property Yes No Yes No Yes No Yes No

If you answered yes to any of the above questions, please attach all documentation to the back page, and list below
the name/s of the person/s who own/s the property and the address and details of the property ownership, including the
value of the property.

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 Household income and asset information continued
Please provide details of the income and asset information for each household member.

Please attach evidence of your income and assets to the back of this application.

Household member 1 2 3 4
Do you have any cash or money in a bank, building society or credit union, including interest free accounts or any
interest-bearing deposits or fixed deposits? If you answer yes to any questions, please attach all
documentation to the back page.
Balance of bank account
Yes No Yes No Yes No Yes No
(including bank, building
society, credit union and
interest free accounts) $ $ $ $

Deposits (interest free Yes No Yes No Yes No Yes No

bearing deposits, fixed)
$ $ $ $
Do you have any bonds, debentures, shares, property trusts, friendly society bonds and managed
investments? If you answer yes to any questions, please attach all documentation to the back page.

Yes No Yes No Yes No Yes No

Bonds
$ $ $ $
Yes No Yes No Yes No Yes No
Debentures
$ $ $ $
Yes No Yes No Yes No Yes No
Shares
$ $ $ $
Yes No Yes No Yes No Yes No
Property Trusts
$ $ $ $
Managed investments Yes No Yes No Yes No Yes No
including friendly society
bonds $ $ $ $
Have you received any superannuation payments in the form of a lump sum or an allocated pension?
If you answer yes to any questions, please attach all documentation to the back page.
Superannuation (please
Yes No Yes No Yes No Yes No
only provide this if you
have reached your
preservation age) $ $ $ $
Date of birth Preservation age

Before 1 July 1960 55

1 July 1960 – 30 June 1961 56
Preservation age table.
1 July 1961 – 30 June 1962 57
1 July 1962 – 30 June 1963 58
1 July 1963 – 30 June 1964 59
After 30 June 1964 60

Have you received a share of a property settlement or sale of a property?

Yes No Yes No Yes No Yes No

Sale of a property
$ $ $ $
Share from a property Yes No Yes No Yes No Yes No
settlement $ $ $ $

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If there are more than four people in your household, please provide details for the additional household members below.

Please attach evidence of your income and assets to the back of this application.

Household member 5 6 7 8
Do you have any cash or money in a bank, building society or credit union, including interest free accounts or any
interest-bearing deposits or fixed deposits? If you answer yes to any questions, please attach all
documentation to the back page.
Balance of bank account
Yes No Yes No Yes No Yes No
(including bank, building
society, credit union and
interest free accounts) $ $ $ $

Deposits (interest free Yes No Yes No Yes No Yes No

bearing deposits, fixed)
$ $ $ $

Do you have any bonds, debentures, shares, property trusts, friendly society bonds or managed investments?
If you answer yes to any questions, please attach all documentation to the back page.

Yes No Yes No Yes No Yes No

Bonds
$ $ $ $
Yes No Yes No Yes No Yes No
Debentures
$ $ $ $
Yes No Yes No Yes No Yes No
Shares
$ $ $ $
Yes No Yes No Yes No Yes No
Property Trusts
$ $ $ $
Managed investments Yes No Yes No Yes No Yes No
including friendly society
bonds $ $ $ $

Have you received any superannuation payments in the form of a lump sum or an allocated pension?
If you answer yes to any questions, please attach all documentation to the back page.
Superannuation (please
Yes No Yes No Yes No Yes No
only provide this if you
have reached your
preservation age) $ $ $ $
Date of birth Preservation age

Before 1 July 1960 55

1 July 1960 – 30 June 1961 56
Preservation age table.
1 July 1961 – 30 June 1962 57
1 July 1962 – 30 June 1963 58
1 July 1963 – 30 June 1964 59
After 30 June 1964 60

Have you received a share of a property settlement or sale of a property?

Yes No Yes No Yes No Yes No

Sale of a property
$ $ $ $
Share from a property Yes No Yes No Yes No Yes No
settlement $ $ $ $

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Are any of the household members on the application expecting a child? Yes No

If yes, name of the person/s

Expected date of delivery (due date)

How many bedrooms do you want to be listed for? Please tick the applicable box/es.

1 2 3 4 5 6 7+

Remember - in general, the more bedrooms a property has, the higher the rent will be.

Does anyone in the household need any of the following features to assist them in their daily living activities?

Note - please tick all situations that apply to your household.

Wheelchair access to the property and within the property

Modified bathroom to assist with bathing, and so on

Modified kitchen to assist with cooking

Other - please provide details below

Which National Rental Affordability Scheme properties do you want to apply for?

For details of National Rental Affordability Scheme properties that are available for rent, please refer to the www.realestate.com.au
web site using the following URL https://m.realestate.com.au/rent/in-qld/list-1?keywords=nras&source=refinements or by
telephoning 13 QGOV (13 7468) between 8:30am and 4:30pm Monday to Friday. Please nominate the suburb name for each National
Rental Affordability Scheme property you wish to list for.

Choice 1. Choice 4

Choice 2. Choice 5.

Choice 3. Choice 6.

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 Declarations - you must complete and sign this application form in accordance with the requirements set out below.
I understand:

 that accommodation made available through the National Rental Affordability Scheme is not social housing. The Department of
Communities, Housing and Digital Economy has no involvement in the ownership of properties, allocation of tenants or
management of tenancies under the scheme and cannot take responsibility for tenancy outcomes,

 the instructions given on this form and note the Privacy Notice below,

 that this form will be used by the Department of Communities, Housing and Digital Economy to register my application for the
National Rental Affordability Scheme, provided I am eligible for assistance under that scheme,

 that all or part of my personal information may be given to non-government agencies to assist in referring my application to
National Rental Affordability Scheme tenancy managers,

 that I may become ineligible for assistance under the scheme if changes occur to any of my, or members of my household’s
circumstances and/or incomes and/or assets detailed in this application,

 that the Department of Communities, Housing and Digital Economy will refer my details to National Rental Affordability Scheme
tenancy managers who will make the final decision on who is approved to rent their properties, and

 that at the time of signing any residential tenancy agreement with an approved tenancy manager under the National Rental
Affordability Scheme, I must produce income and other details that verify I am still eligible for the scheme, and

 that I must produce income and other details that verify I am still eligible for the scheme.

I understand:

 that I have to offer at least one item from both the primary and secondary list of items below as proof of my identity (one must
show a Queensland address, applicant’s signature and date of birth):

Primary Secondary
Full birth certificate or extract of birth certificate Bank, credit card or ATM card with your signature
Passport Apprenticeship indenture papers
Driver’s licence with photograph Other recognised photographic I.D.
(e.g. security identification, Cash Converters Card)
18 plus card with photograph Recent bank statements, bank book, credit union or building
society statement showing recent transactions

Queensland shooter’s licence with photograph Original Australian marriage certificate or divorce papers
Immigration papers or other documents issued by Life insurance policies
the Commonwealth Department of Immigration
Occupational registration documents
and Citizenship
Naturalisation or citizenship certificate Taxation Notice of Assessment
Pensioner Health Benefit Card or Centrelink’s Customer
Reference Number (CRN) on the official document or
correspondence
Medicare Card
Student Card with photograph

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Personal Information Privacy Notice
The Department of Communities, Housing and Digital Economy is collecting personal information on this form to provide you with housing assistance in connection
with the National Rental Affordability Scheme. To assist you with your housing needs and services, relevant personal information may be disclosed to: tenancy
managers of National Rental Affordability Scheme properties, partner agencies, service providers, agencies authorised by legislative provisions, and local
governments and non-governmental agencies that will provide you with housing and/or support services. Limited personal information may be used for housing
related research, policy or planning functions. Unless authorised or required by law, your personal information will not be passed on to any other third party
without your consent. More information about the department’s privacy policy is available on our website at https://www.chde.qld.gov.au/about/information-
privacy.

Declaration
To the best of my knowledge, the information provided on and in conjunction with this form is true and correct. I understand that I will commit
an offence and be liable to a penalty under the Housing Act 2003 if I knowingly provide to Department of Communities, Housing and Digital
Economy false or misleading information that may influence decisions about my eligibility for housing services and may make my application
invalid.
Name of applicant/s

Signed by the applicant/s Date

/ /
Full name of witness Position

Signature Date / /
The witness must be either a Justice of the Peace/Commissioner for Declarations or a solicitor or an officer of the Department of Communities,
Housing and Digital Economy or an executive officer of a registered community housing provider. The witness must also sight two of the
identification items for each applicant.

Declaration for people completing this form on behalf of the applicant

This form has been filled out with the information the applicant/s supplied to me. I have drawn the applicant’s attention to the contents of this
form, including item 11, and I believe the applicant understands the contents.

Attachments
Please attach documents here if requested in this application. For example:
 Proof of identity (one primary and one secondary form of evidence from the above list)
 PH005-1: ‘Formal Guardian and/or Administrator Details’ - if required
 PH005-2: ‘Informal Decision-maker Details’ - if required
 Evidence of applicants and household members’ income and assets
 Evidence of applicant’s Australian citizenship or permanent residency
 PH071 - Authority to request or disclose personal information to external parties

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