INFORMATION FORM FOR PROSPECTIVE TENANTS

NON-STUDENTS

Please complete this information form for prospective tenants in full. Please remem-
ber to sign the agreement regarding the credit investigation company (Schufa).

The following documents have to be enclosed with the information form:

Copy of identity card (or document used in place of ID card)

1 current passport photograph

Salary statements or remuneration statements covering the last three months

In the case of self-employed applicants: a business activity statement

regarding the last three months

In the event of new employment being started: copy of the employment

contract

Confirmation of liability insurance

YOUNIQ Potsdam
MicroLiving Service GmbH · Augustusplatz 9 · 04109 Leipzig
Tel.: +49 (800) 4-YOUNIQ (0800 4968647) · Fax: +49 (69) 247472100
potsdam@youniq.de · www.youniq.de
Please select your location:
Jochen-Klepper-Straße 1-7

Rented from:

Name:

First name:

Nationality:

Date of birth:

Current address

Street

Postal code

City

Country/state

ID card/passport no.

Telephone/mobile phone:

E-mail address:

Occupation:

Employer:

Monthly net income:

Will you need a car parking space? Car/vehicle registration:

Are there any attachments of wages or salary, assignments or repayment agreements currently in force?
If yes, for what amount?

Current landlord:
Address and telephone no.:

Monthly rent:

Has an action for eviction ever been enforced against you?

If yes, in which year?

YOUNIQ Potsdam
MicroLiving Service GmbH · Augustusplatz 9 · 04109 Leipzig
Tel.: +49 (800) 4-YOUNIQ (0800 4968647) · Fax: +49 (69) 247472100
potsdam@youniq.de · www.youniq.de
 Furthermore, I allow the company listed below and authorised to furnish information to obtain a report
from SCHUFA (a credit investigation company) containing information on me in accordance with the
separate statement to this end. This statement is part of this voluntary disclosure of information and is
provided separately in a signed form.

Credit Investigation Provision regarding Rent Applications

I agree that MicroLiving Service GmbH, Augustusplatz 9 in 04109 Leipzig may forward information regar-
ding the application for this tenancy agreement to SCHUFA Holding AG, Kormoranweg 5, 65201 Wies-
baden and that it can receive information relevant to me provided by SCHUFA.

Regardless of this, MicroLiving Service GmbH will also forward information regarding the company’s
outstanding accounts receivable from me (e.g. amount of account receivable after execution subsequent
to a termination of the contract according to art. 543 paragraph 2 figure 3, art. 569 paragraph 3 BGB
[German Civil Code] or on grounds of default in payment according to art. 573 paragraph 2 figure 1 BGB)
to SCHUFA. In accordance with the German Federal Data Protection Act (art. 28 a paragraph 1 sentence
1), this is permissible if the performance owed has not been effected even though it has fallen due, if the
transfer of such information is required to preserve the justified interests of the landlord or of third parties
and the claim is enforceable or if you have expressly recognised the account receivable.

In addition to this, MicroLiving Service GmbH will also report other conduct which is not compliant with
the contract (e.g. fraudulent or abusive behaviour) to SCHUFA. According to the German Federal Data
Protection Act (art. 28 paragraph 2), such messages may only be submitted in as far as this is required
to preserve the justified interests of YOUNIQ Service GmbH or of third parties and in as far as there is no
reason to assume that the legitimate interests of the party concerned in the exclusion of such a transmis-
sion outweighs their interests.

SCHUFA saves and uses the data received. This use also includes the calculation of a probability on
the basis of the SCHUFA database in order to assess the credit risk (score). They then forward the data
determined to their contracting partners within the European Economic Area and Switzerland in order to
provide said partners with information to assess the credit worthiness of natural persons. The contrac-
ting partners of SCHUFA include companies that are subject to the risk of financial default on account
of services and deliveries (such as, in particular, credit institutions and credit card or leasing companies
but also leasing, retail, telecommunications, energy supply, insurance and debt collection companies).
SCHUFA only provides personal data if a justified interest in such can be demonstrated plausibly and if the
transmission is permissible after weighing of all interests. For this reason, the scope of the respective data
made available can differ depending on the type of the contracting partners. In addition to this, SCHUFA
uses the data to check the identity and age of persons upon a request to this end by its contracting part-
ners that e.g. offer services on the Internet.

YOUNIQ Potsdam
MicroLiving Service GmbH · Augustusplatz 9 · 04109 Leipzig
Tel.: +49 (800) 4-YOUNIQ (0800 4968647) · Fax: +49 (69) 247472100
potsdam@youniq.de · www.youniq.de
 I can receive information on data stored regarding me from SCHUFA. Further information on the SCHUFA
reporting and scoring procedure is available at www.meineschufa.de. SCHUFA has the following mailing
address:

SCHUFA Holding AG, Consumer Service, PO box 5640, 30056 Hanover

Signature of prospective tenant

The prospective tenant hereby warrants that the information above is true, that he/she has sound finan-
ces and that bankruptcy or composition proceedings regarding his/her assets have not been opened
over the last five years, that he/she has not issued a declaration in lieu of an oath regarding his/her finan-
cial circumstances or that an arrest warrant has not been issued to enforce such a statement in lieu of
oath or that corresponding proceedings are not pending.

Signature of prospective tenant

YOUNIQ Potsdam
MicroLiving Service GmbH · Augustusplatz 9 · 04109 Leipzig
Tel.: +49 (800) 4-YOUNIQ (0800 4968647) · Fax: +49 (69) 247472100
potsdam@youniq.de · www.youniq.de