Tenancy
Bond refund form
All sections of this form must be completed to enable smooth processing of information
Make sure you write in all the boxes that apply to you. Tenancy Services will be unable to release the bond until all tenants have
signed the form and indicated how much each tenant is to receive
Complete in a black or blue pen with CAPITAL leers if handwriting. Do not sign this form until all information has been entered
Read the important information on the back of this form before entering any details
1
Bond number:
2
Date tenancy ended
D D M M Y Y
3
Address of the rented property Property ID:
Room no.
(for boarding house
or room only tenancy)
Unit
House no.
Street
Suburb
City
Building name
Postcode
4
Refund details
Please countersign any alterations you make or your refund may be delayed. This section must be completed before any signatures are entered
Pay the landlord(s)
Pay the tenant(s)
Hold in dispute
TOTAL
Landlord’s reason(s) for claiming some or all of the bond
Arrears
Repairs
Cleaning
Outgoings
Other
T2 (05/18)
6b
Tenant 1 new address for service Email will be first point of contact if provided
Email
Room no.
(for boarding house
or room only tenancy)
Unit
House no.
Street
Suburb
City
PO Box or
Private Bag
Postcode
By signing this form you agree that the
infor mation you have provided is true and correct
Signature
Date
D D M M Y Y
6a
Tenant 1 details
Full name
Contact phone
Tenant 1 to receive
Bank account
This must be a New Zealand bank account.
7b
Tenant 2 new address for service Email will be first point of contact if provided
Email
Room no.
(for boarding house
or room only tenancy)
Unit
House no.
Street
Suburb
City
PO Box or
Private Bag
Postcode
By signing this form you agree that the
infor mation you have provided is true and correct
Signature
Date
D D M M Y Y
7a
Tenant 2 details
Full name
Contact phone
Tenant 2 to receive
Bank account
This must be a New Zealand bank account.
5a
Landlord details
Landlord ID:
Contact phone
Full names or trading name
Bank account
Reference
to appear on your bank statement
5b
Landlord address for service Email will be first point of contact if provided
Email
Unit
House no.
Street
Suburb
City
PO Box or
Private Bag
Postcode
Landlord Signatures
Date
D D M M Y Y
By signing this form you agree that the
information you have provided is true and correct
This must be a New Zealand bank account
Use the
Additional tenants bond refund form
if more than
2 tenants. Attach it to this form.
Yes, this form is attached.
vv
Tenancy
If you need to add more tenants, please use the
Additional tenants bond refund form
and aach it to this form.
Privacy statement
Information provided on this
form will be held and used by the
Ministry of Business, Innovation and
Employment for the purposes of
enforcing and administering the
Residential Tenancies Act 1986.
It may also be used for carrying out
customer surveys, public education
and statistical analysis, and we may
occasionally provide your information
to third parties to carry out this work
on our behalf.
The personal information you supply
will not be used for any other reasons
unless permied under the Privacy
Act 1993 (e.g. with your consent or
for a directly related purpose). The
information may also be provided
to third parties where it is required
or permied by law. The personal
information you supply will be
provided to all parties named on this
form or on the bond record. You can
access or correct your personal
information held by us at any time.
Bond number
This is the bond number for the
previous tenancy address. It is on all
our leers to you about this rented
property. If you do not have it please
call us.
Date tenancy ended
It is important that you include the
date the tenancy finished, as agreed
between the tenant and the landlord.
This date can affect the way the bond
is paid out.
Property ID number
If you do not know the Property ID
number for this property, leave the
box blank.
Refund details
This section shows how you have
agreed the bond money will be paid
out to the tenant, landlord or both.
If the landlord wishes to claim some
or all of the bond money, they must
indicate the reason why using the
tick-boxes.
If there is any amount that you
cannot agree on, this should be
wrien in ‘Hold in Dispute’. This
amount will not be paid out until
agreement is reached or until a
mediated/Tenancy Tribunal order
ismade.
Landlord refund details
The landlord(s) should complete this
section.
Landlord ID number: If you do not
know this number, leave the box
blank.
Tenant refund details
The tenant(s) should complete
this section.
Address for service
This information will assist Tenancy
Services to contact you regarding this
bond and to minimise any delays in
paying out/refunding the bond when
the tenancy finishes.
Landlord’s address for service:
If you provide an email address, we
will use this as the primary means for
communication. However, a physical
address must also be provided.
If we need to contact you at a street
address regarding this tenancy we
will use the address for service you
provided.
In addition to a street address,
a PO Box address can also be
provided as an address for service.
Tenant’s address for service:
If you provide an email address,
wewill use this as the primary means
for communication. If we need to
contact you at a street address
during your tenancy we will use the
address of the rented property or the
address for service you give us. A new
address for service is required aer
the tenancy has ended.
In addition to a street address,
a PO Box can also be provided to
be used as an address for service.
PLEASE NOTE: By providing a
PO Box or email address, you are
authorising Tenancy Services to use
these to contact you.
Any questions?
All our forms and other information
are on our website at
www.tenancy.govt.nz
If you have any questions about
this form or need more information
about bonds, please Freephone
0800 737 666 or contact us by email
at www.tenancy.govt.nz/contact-us
Ki te mea he pātai āu mō tēnei puka,
kei te pīrangi pārongo rānei mō te
moni here (bond), waea koreutu
0800 737 666, whakapā rānei ki a
mātou i te īmēra
www.tenancy.govt.nz/contact-us
A iai ni fesili e uiga i lenei pepa pe
mana’omia fo’i nisi fa’amatalaga e
uiga i le tupe fa’amau (bond),
fa’amolemole telefoni mai i le numera
0800 737 666, pe feso’ota’i mai ile
emeli
www.tenancy.govt.nz/contact-us
若您有任何关于本表格方面的疑问, 或是
希望获得 有关押金的更多详情, 请拨打
们的免费热线电话 0800 737 666, 或发
送电邮至以下网站内的相应电邮 地址,
与我们联系:
www.tenancy.govt.nz/contact-us
If you have questions about your
rights and obligations when renting
call our tenancy information line
Freephone: 0800 TENANCY
(0800 83 62 62)
Send us your form
The fastest way to get your
form to us is by emailing it
to bonds@tenancy.govt.nz,
or post it to Tenancy Services,
PO Box 50445 Porirua 5240
MBIE 3639T2 (05/18)
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