Fillable Form Number 1 (version 3): QCAT Application for (Department of the Environment and Energy)

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Form Number 1 (version 3): QCAT Application for (Department of the Environment and Energy)

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The Form Number 1 (version 3): QCAT Application for (Department of the Environment and Energy) form is 4 pages long and contains:

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  • 13 check-boxes
  • 41 other fields

Country of origin: AUSTRALIA
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For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
Application for minor civil dispute – consumer dispute – page 1 of 4
Refer to attached instructions prior to lling out this form.
Form Number 1 (version 3)
Queensland Civil and Administrative Tribunal Act 2009 (section 33)
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
Application for minor civil dispute –
consumer dispute
For ofce use only
Case number:
Date eld:
Registry:
Fee paid:
Receipt number:
PART A APPLICANT’S DETAILS
INFORMATION FOR RESPONDENTS
You cannot le a formal response to this application however you may le written submissions in the tribunal
attaching copies of any documents upon which you wish to rely. You must also give a copy of your submissions
and any attachments to the other party as soon as possible after it has been led.
You may also le a counter-application against the applicant to this application or against another person.
Counter-applications must be made in the Form 8 - minor civil dispute - counter-application and lodged with
the tribunal.
APPLICANT’S DETAILS
Name
Address
Postcode
Contacts
( ) ( )
Preferred phone number Alternative number Email
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
Application for minor civil dispute – consumer dispute – page 2 of 4
Representative’s details (if applicable)
Tick if you want this to be your address for notices
Tick if you want your representative to represent you in proceedings before the tribunal (see Part A
of the instructions – you may be required to seek the tribunal’s leave for this to happen by making an
application under the Form 56 - Application for leave to be represented. The tribunal may not give you leave
to be represented.)
Name
Address
Postcode
Contacts
( ) ( )
Preferred phone number Alternative number Email
PART A APPLICANT’S DETAILS
PART A RESPONDENT’S DETAILS
RESPONDENT’S DETAILS
Name
Address
Postcode
Contacts
( ) ( )
Preferred phone number Alternative number Email
PART B GENERAL DISPUTE DETAILS
1. What are you seeking? Tick applicable and insert amount. If ticked, please include details in
Part C below.
payment of money to me
$
refund of money to me
$
relief from payment of money by me
$
return of goods
$
rectication of work
$
costs of transporting a motor vehicle to the respondent if claimable
$
payment of the ling fee for this application
$
TOTAL
$
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
Application for minor civil dispute – consumer dispute – page 3 of 4
PART C DETAILS OF WHAT YOU SEEK FROM THE TRIBUNAL
If there is insufcient space here, please attach additional pages.
1. I want the tribunal to make the following order/s:
Insert orders sought in numbered paragraphs.
2. The reason I am seeking orders from the tribunal
Outline the basis for your claim, including details of any agreement or contract and attach the documents
you seek to rely on. Please refer to the instructions for completing this form for assistance with what
information may be required.
PART C DETAILS OF WHAT YOU SEEK FROM THE TRIBUNAL (continued)
If there is insufcient space here, please attach additional pages.
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
Application for minor civil dispute – consumer dispute – page 4 of 4
PART D CHECKLIST AND SIGNATURE
I have completed all questions on the application form according to the instructions
I have provided the correct number of copies of the application form and attachments
(for the number of copies required – see the instructions)
I have paid the prescribed fee
I am ready to proceed with this application
INTERPRETER
Is an interpreter required? The assistance of an interpreter is subject to approval by the tribunal.
Yes No
If YES, please specify language
WARNING
Section 216 of the Queensland Civil and Administrative Tribunal Act 2009 makes it an offence for a
person to knowingly give the registry documents containing false or misleading information. Maximum
penalty for such an offence – 100 penalty units.
SIGNATURE
The information in this application is true to the best of my knowledge.
Applicant/s sign here
If more than one applicant is named all must sign the application.
Date
Select Date
click to sign
signature
click to edit
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
Use this form if your claim is not more than $25,000 and is
• Between a consumer and a trader about goods or services;
• Between traders about goods or services
• A dispute about property damage caused by a motor vehicle incident; or
• A dispute about the repair of a defect in a motor vehicle.
A “consumer dispute” is between a consumer and a trader, or between traders.
Consumer and trader disputes involve disputes against trader arising out of a contract for the supply
of goods or services, valued up to and including $25,000.
For example:
• Goods include food, clothes, appliances and furniture;
• Services include repairing a defect in a motor vehicle, car maintenance, meals served in
restaurants and a haircut by a hairdresser.
However, your dispute may be a debt dispute not a consumer and trader dispute, if it is about a xed
or agreed sum of money valued up to and including $25,000 e.g. a debt resulting from overhanging
branches an IOU or money lent and not repaid. If your dispute is for an agreed sum of money
you may need to complete the Form 3 – application for minor civil dispute – minor debt. For more
information visit www.qcat.qld.gov.au or call 1300 753 228.
Who is a trader?
Please refer to the denition of “trader” in the Queensland Civil and Administrative Tribunal Act 2009.
A trader is a person who in trade or commerce has a business that supplies goods or provides
services. However, a trader is not a person who supplies goods or provides services if that work is
not ordinarily regarded as being within trade or commerce. Examples of persons who are not within
the denition of traders are lawyers, dentists, valuers, podiatrists or professional town planning
consultants.
HOW TO COMPLETE FORM 1 – APPLICATION FOR MINOR CIVIL DISPUTE –
CONSUMER DISPUTE
Copies of the application and providing copies to other parties
When lodging your original application and any attachments, you must also provide two copies of all
of the documentation being lodged and a stamped, self-addressed envelope. If there is more than
one respondent, you must include an extra copy of the application form and attachments for each
additional respondent.
The tribunal will return sealed copies to you, at the address you provide.
Generally, you must then give a copy of the application to all parties to the proceeding as soon as
practicable, and no later than seven (7) days after the application is led.
Application for minor civil dispute –
consumer dispute
Instructions for completing
Instructions for completing - Application for minor civil dispute – consumer dispute – page 1 of 5
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
Applications may be lodged in person or by post
By post: QCAT, GPO Box 1639, Brisbane QLD 4001
If you are posting your original application and copies to QCAT, you need to include
a stamped self-addressed A4 envelope with your application.
In person: QCAT, Level 11, Bank of Queensland Building, 259 Queen Street, Brisbane QLD 4000,
or at any Magistrates Court outside of the Brisbane CBD.
To nd your nearest Magistrates Court, look under “Justice and Attorney-General” in the phone book
or visit www.courts.qld.gov.au. For more information visit www.qcat.qld.gov.au or call 1300 753 228.
Applications must be accompanied by the prescribed application fee
For more information on QCAT fees visit www.qcat.qld.gov.au. Payment can be made by cash,
cheque (payable to Department of Justice and Attorney-General), money order or credit card payment
authorisation (see Credit card payment authorisation form – MasterCard and Visa accepted).
PART A – APPLICANT AND RESPONDENT DETAILS
• More than one applicant or respondent can be named in an application.
• If there is insufcient space for the names of either applicant or respondent, you may attach
additional pages with similar details.
If the applicant or respondent is not an individual then the correct name must be used e.g. a company
name, a business name (whether it is registered or not) or the name of a State agency or department.
You must also state the correct ABN/ACN for the company or business name. Please refer to the
tribunal’s factsheet How to identify and name the parties in QCAT availble at www.qcat.qld.gov.au
Your address will be the address at which documents are given or sent to you, unless you indicate
your representative’s address as your address for notices. If you change your address, you must le
in the tribunal and serve on all other parties a notice of change of contact details form.
Representative’s details
If you want your representative’s address as the address for notices, please complete your
representative’s details. If you want your representative to represent you in any proceedings
before the tribunal you must complete the form Form 56 - Application for leave to be represented.
Generally the tribunal expects people to represent themselves. The decision regarding representation
will be decided by the tribunal.
You are not required to seek leave to be represented if:
• you are a child or a person with impaired capacity
• relevant laws state that you may be legally represented.
COMPLETING PART B – GENERAL DISPUTE DETAILS
Please tick the relevant boxes and provide details.
Instructions for completing (continued)
Instructions for completing - Application for minor civil dispute – consumer dispute – page 2 of 5
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
COMPLETING PART C – DETAILS OF WHAT YOU SEEK FROM THE TRIBUNAL
You must outline what orders you want the tribunal to make and what the dispute is about. Complete
Part C by outlining your claim, the brief facts of the matter and why you want the tribunal to make
the orders you seek. Refer to the information below for guidance about what information the tribunal
needs to make a decision about your application.
DISPUTES ABOUT GOODS OR SERVICES
You may make an application if:
• you are a consumer who feels that a trader has not treated you in the way that was agreed.
• you are a trader who disputes a spoken or written agreement with another trader who has provided
goods or services.
Proving your case - you will need to provide details of your claim to the tribunal.
For disputes about goods:
• write the date of your written or oral agreement with the respondent, for example, the date you
bought the goods
• describe the goods (give the brand name, model number, serial number, registered number, size,
quality, etc.)
• write how much you agreed to pay, including any trade-in
• write the date the goods were delivered
• write the date you paid the amount and the date you delivered the trade-in to the respondent
• write what was said by the respondent about the quality of the goods or the way they would
perform. Who made the statements? What was their position in the company or business?
• briey describe the problems you have had with the goods
• explain any repairs, and how much they cost – the amount will be the amount of your claim. Attach
any written invoices/quotes or receipts
• explain what must be done to correct the problems or faults, attach any written quotes or reports
• if the goods cannot be repaired, set out how much it will cost to replace them and attach a
written quote
For disputes about services:
• write the date of your written or oral agreement with the respondent, for example the date you
accepted the quote
• briey describe the services the trader agreed to provide
• write the amount you agreed to pay
• write the date on which the trader provided the services
• write the date and amount you paid
• briey describe the problems you have had with the services
• explain any problems, and how much they cost to x – the amount will be the amount of
your claim. Attach any written invoices/quotes or receipts
• explain what must be done to correct the problems or faults, attach any written quotes or reports
• if the problems cannot be xed, mention how much it will cost to replace the services and attach a
written quote
Instructions for completing (continued)
Instructions for completing - Application for minor civil dispute – consumer dispute – page 3 of 5
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
Instructions for completing (continued)
FOR A DISPUTE ABOUT THE REPAIR OF A DEFECT IN A MOTOR VEHICLE
You may make an application for the repair of a defect in a motor vehicle which is under a
statutory warranty.
Proving your case - you will need to provide details of your claim to the tribunal.
• write the date that the motor vehicle was bought
• write the make and model of the vehicle, and the year it was manufactured
• write the odometer reading at time of purchase
• attach a copy of the defect notice that was given to the respondent, and write the date that the
defect notice was given
• write how far away (the distance in km) the respondent resided or had their place of business from
your residence or place of business and the costs of transporting your vehicle to the respondent
• if the respondent refused to accept the motor vehicle, write the date of refusal
• indicate whether the vehicle was repaired within 14 days of the respondent accepting the
motor vehicle
• indicate whether the defect has not been repaired properly
• write the day that the respondent, or their nominated repairer, accepted the vehicle
• attach a copy of the repair invoice
FOR DISPUTES ABOUT PROPERTY DAMAGE CAUSED BY A VEHICLE
• write the time, date and place of the incident
• write the make and model of your vehicle (if applicable), the registration number and who was
driving it at the time of the accident
• write the make and model of the respondent’s vehicle, the registration number and the name and
address of the driver (and if appropriate, the name and address of the owner or employer)
• explain how the incident happened fully and simply and say what the other driver did
• attach an extra sheet of paper to your claim and draw a sketch of what happened. Show street
names, the location of trafc signs and lights, the number of trafc lanes, the position of trafc
islands and double lines, and the position of each vehicle at the time of collision. Please mention if
the driver was charged by the police with a trafc offence
• write how much you were quoted for repairs and attach any quote(s). Obtain written quotes for
both labour and parts – the amount of your claim should be the quote you think is reasonable. You
will need to get a quote and afdavit from the repairer
• If the cost of repairs to your vehicle is more than the vehicle is worth, get a loss assessor/adjuster
to give a written valuation of your vehicle before it was damaged. The loss assessor should also ll
out an afdavit
PROVING YOUR CASE
Have you included a copy of all the relevant documents and evidence? Y
ou must include a
copy of all of the relevant documents that you want to use and rely on.
You must print out all electronic evidence
Sometimes evidence (such as photos or receipts) may be stored in an electronic device, such as a
mobile phone, tablet or computer. Sometimes evidence may be stored on a CD or DVD. You must
provide a printed copy of this evidence with your application if you wish to use and rely on it at the
hearing. The Tribunal will not accept a CD or DVD for ling and will not consider evidence provided
only in an electronic format.
Instructions for completing - Application for minor civil dispute – consumer dispute – page 4 of 5
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
Instructions for completing (continued)
Witnesses
If you have a witness, that person should complete an afdavit setting out their evidence. Y
ou should
provide this evidence before the hearing. Your witness may be required to answer questions at the
hearing. If the witness cannot attend the hearing in person, they should be available by telephone.
Your Information
QCAT collects your contact details for the purposes of compliance with the Queensland Civil and
Administrative Tribunal Act 2009 in relation to proceedings in QCAT. QCAT may contact you to seek
your assistance in research to assist in the evaluation of the operation of QCAT
. You are not obliged
to participate in feedback or surveys. If you do participate no identifying particulars will be published.
QCAT will not disclose your contact details or any other personal information to a third party unless
required by law.
Instructions for completing - Application for minor civil dispute – consumer dispute – page 5 of 5
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Form Number 1 (version 3): QCAT Application for (Department of the Environment and Energy)

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Completed 6 October 2020

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