Repair Request

Please be as specific as possible when filling in this form.  For eg, stipulate whether the appliance is gas or electric and include model numbers where possible.  Thank you – we’ll get onto the job right away!

  • Max. file size: 25 MB.
  • IMPORTANT NOTE:

    Please note your individual real estate and corporation licence application forms should not state the trading name as Living Here. The Office of Fair Trading should be advised of this only once the Licence Agreement has been signed. Instead please note your company/individual name in this section.
  • APPLICATION FOR LICENCE

  • 1. OFFICE DETAILS

    The business names of our offices appear as Living Here (Suburb). Please confirm your details:
  • (At least 1 month from date of application, all real estate licences and insurances must be in place prior to this date)
  • 2. APPLICANT – PERSONAL DETAILS

  • Contact details:

  • 3. BUSINESS OWNER ENTITY AND DETAILS

  • IMPORTANT NOTE An office cannot attach or use the Business Name, the Living Here Name, the initials 'LH', or any combination of the above as a part of any corporate name. For example, if your company is registered as “LH North West Pty. Ltd.” then the company name will need to be changed to REMOVE the initials “LH”. If you need any assistance with the company name change, please don’t hesitate to contact the Franchise Legal Team on (07) 3231 2200.
  • Trust Entity details (if applicable):

    (if the Trust Entity is noted on your Trust Account receipt book, please provide a copy of the deposit slip)
  • COMPANY DIRECTORS NAMES AND HOME ADDRESSES:
  • This person will also be a guarantor
  • This person will also be a guarantor
  • This person will also be a guarantor
  • LEASE DETAILS

  • 4. BUSINESS EXPERIENCE/EMPLOYMENT HISTORY

  • 5. REFERENCES

  • BUSINESS REFERENCES Please provide names and contact numbers of three business referees who may be contacted about your application. These people may be asked to provide information about your past/present work performance or business skills. It is advisable to enclose a written reference from them.
  • CHARACTER REFERENCES

    Please also include details of two persons who may be contacted for a character reference.
  • 6. LEGAL CONSIDERATIONS

  • 7. FINANCIAL DETAILS

  • 8. LICENCES

    PLEASE NOTE: NO LICENCE AGREEMENT WILL BE EXECUTED UNLESS A COPY OF YOUR CURRENT REAL ESTATE LICENCES ARE ENCLOSED WITH THIS APPLICATION (TOGETHER WITH ALL CURRENT INSURANCES/CERTIFICATES OF CURRENCY)
  • For - Individual (Copy of licence MUST be enclosed)

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  • Corporation (Copy of Corporation’s licence & licence of the Licensee in Charge MUST be enclosed)

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  • All -

  • PRIVACY

  • PRIVACY DISCLOSURE STATEMENT We are an independently owned and operated business. We are bound by the National Privacy Principals. We collect personal information about you in this form to assess your application for eligibility as a business owner. We may need to collect information about you from your accountant, solicitor, nominated bank, your referees, relevant real estate licensing authorities, ASIC and credit reference database. The information on this Application will be held on our database and used by us. Your consent to us collecting this information is set out below. When the application is successful we may disclose your details to service providers relevant to the relationship between licensee and Living Here. You have the right to access personal information that we hold about you by contacting our privacy officer at Living Here Pty Ltd GPO Box 2433, Brisbane, Queensland, 4001; Telephone (07) 3231 2200 Facsimile: (07) 3831 9117. If you do not complete this form or do not sign the consent below then your application can not be processed and will not be considered.
  • PRIVACY CONSENT I/We, the Applicant/s acknowledge that I/We have read the above Privacy Notice. I/We authorise Living Here to collect information about me/us from my/our accountant, solicitor, nominated bank, referees, the relevant licensing authorities, ASIC and credit reference database. I/We also authorise Living Here to refer my/our details to other entities that are part of the Ray White Group, including, without limitation, Loan Market, Concierge (Ray White Insurance), White & Partners, Ray White Constructions and APMASPHERE).
  • DD slash MM slash YYYY
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  • DECLARATIONS I have completed this Licence Agreement application form to the best of my ability and warrant that all the information provided in it is true and correct. I understand that failure to make full disclosure may be construed as a misrepresentation by silence. I understand that any wrongful statements made by me are misrepresentations of fact. I undertake to keep confidential all commercially sensitive, proprietary Living Here information and information of a confidential nature, provided to me in the course of discussions and negotiations in relation to making application for a Living Here office. I authorise Living Here to make any enquiries that it considers necessary to fully assess this application. I understand Living Here may accept or reject this application in whole or in part in its absolute discretion and that there is no binding agreement with Ray White until a Licence Agreement is executed.
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  • If the applicant is a company - a director of the company may complete this form. We may require further information, in due course, from each director and officer associated with the company. All guarantors must also sign as applicant.

    If the applicant is a partnership – each partner must complete a separate form. All guarantors must also sign as applicant.

    If several individuals or entities or a combination of individuals and entities, wish to apply jointly, then each legal entity must complete a separate form. All guarantors must also sign as applicant.