1. Personalia Applicant Last name: First name: Email address: Daytime Phone Date of birth: Nationality Citizen Service Number Relational Status MarriedSingleDivorced Partner / Live companion Name First name: Email address: Phone number: Date of birth: Nationality Citizen service number: Relational Status MarriedSingleDivorced Residents Number of children 0123Meer Ages: Gender Pets Animal Species: Number of pets: 0123Meer 2. Preferred Property Place Street: Reason apply/move: Preferred date of commencement: 3. Current living situation Current Address Postalcode + Place Current type of accommodation: EengezinswoningAppartementKamerAnders Current living form: KoopwoningHuurwoningInwonenAnders Current monthly housing costs (not applicable for parking places / garages): € bruto a month 4. Income information Applicant Occupation: Employer: Name: Address: Place: Phone number: Gross salary: € a month Other income € a month Possible financial obligations: (loans, alimony et cetera) Partner / Life companion: Occupation: Position: Employer: Name: Address: Place: Phone number: Gross salary: € per maand Other income: € per maand Possible financial obligations: (loans, alimony et cetera) Applicant: declares filling out all above questions truthfully gives permission to confidential check out completed data No rights can be derived from filling out this application form concerning getting the desired property.