Fillable Form Number 9 (version 3): QCAT Afdavit of (Department of the Environment and Energy)

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Form Number 9 (version 3): QCAT Afdavit of (Department of the Environment and Energy)

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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
Afdavit of service – page 1 of 5
Refer to attached instructions prior to lling out this form.
Form Number 9 (version 3)
Queensland Civil and Administrative Tribunal Rules 2009 (Rule 42)
PART A APPLICANT’S AND RESPONDENT’S DETAILS
Case number (if known):
Applicant
Respondent
For ofce use only
Case number:
Date:
Registry:
Afdavit of service
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
Please note that this is an afdavit. Each of the following
pages must be signed by the person making the afdavit in the
presence of a qualied witness (the person taking the afdavit).
For more information on QCAT: Call 1300 753 228 or visit www.qcat.qld.gov.au
QCAT
Queensland Civil and Administrative Tribunal
Person making afdavit to sign Person taking the afdavit to sign (qualied witness)
Afdavit of service – page 2 of 5
PART B DETAILS OF SERVICE
I,
(insert full name of person making afdavit)
of (insert residential or business address, or place of employment)
Postcode
state on oath / solemnly and sincerely afrm and declare:
On the
/ / 20
at am / pm,
I served
(insert name of person or entity/s served)
a copy of
(insert name of document/s)
led on
/ / 20
at the Queensland Civil and Administrative Tribunal
(insert tribunal address)
as follows: (For personal service please complete part B1, for other service please tick relevant boxes in
parts B2 and B3)
PART B1 PERSONAL SERVICE
Note: personal service is required for applications for minor civil dispute - minor debt claims.
1. I delivered the copy to him her them
personally at
(insert address)
Postcode
2. I identied the person served by
(insert means of identication)
YY
MM
DD
YY
MM
DD
HH:MM
click to sign
signature
click to edit
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
Person making afdavit to sign Person taking the afdavit to sign (qualied witness)
Afdavit of service – page 3 of 5
I sent the copy by post to the address in the entity’s address for service, namely (insert address)
I sent the copy by post to the address in accordance with the service practice direction to which
documents may be posted in circumstances where the entity does not have an address for service,
namely (insert address)
I faxed the copy to the fax number
( )
that was included in the entity’s
address for service.
PART B3 OTHER SERVICE
Postcode
Postcode
I left the copy at the company’s registered ofce, namely
I posted the copy to the company’s registered ofce, namely
I served the copy otherwise in accordance with section 109X of the Corporations Act 2001
(Commonwealth), namely
(insert method of service)
PART B2 SERVICE OF A COMPANY
Postcode
Postcode
click to sign
signature
click to edit
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
Person making afdavit to sign Person taking the afdavit to sign (qualied witness)
Afdavit of service – page 4 of 5
PART B3 OTHER SERVICE (continued)
I emailed the copy to the email address that was included in the entity’s address for service.
(insert email address)
I electronically transmitted the copy to the non-fax or email electronic address that was included in the
entity’s address for service (e.g. via a website)
(insert electronic address)
I left the copy with a person (insert name)
who is apparently an adult and apparently residing or employed at the entity’s address for service, namely
(insert address)
I left the copy with a person (insert name)
who is apparently an adult and apparently residing or employed at the address in accordance with the
service practice direction at which documents may be left with a person in circumstances where the entity
does not have an address for service, namely (insert address)
I served the copy in another way in accordance with the service practice direction, namely
(insert method of service)
I served the copy in accordance with the tribunal’s direction, namely by
(insert method of service)
I otherwise served the copy in accordance with an Act
(insert method of service)
Postcode
Postcode
(insert name of Act)
namely by
click to sign
signature
click to edit
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
Afdavit of service – page 5 of 5
PART C DOCUMENT SERVED
One of the following must apply, please tick as appropriate:
I have attached to this afdavit a copy of the document served, or
I have already led the document which is named above in Part B.
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.
PART D INTERSTATE SERVICE
This part only applies if you served the document interstate. Tick as applicable.
I did attach the notice under the Service and Execution of Process Act 1992 (Commonwealth) to the document.
I did not attach the notice under the Service and Execution of Process Act 1992 (Commonwealth) to the document.
SIGNATURE
Sworn (or afrmed) by (insert full name)
on
/ / 20
at (place)
in the presence of:
Person making afdavit to sign Person taking the afdavit to sign (qualied witness)
Print name
Commissioner for declarations / solicitor /
justice of the peace
YY
MM
DD
click to sign
signature
click to edit
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
Afdavit of service
Instructions for completing
Use this form where you are seeking, or are required, to prove that you have provided a copy
of a document to another party.
Default decisions
Where you are applying for a decision in default of a response by a respondent you will need to prove
that you have provided a copy of your application to the respondent. Y
ou may complete this afdavit,
or in some cases you may complete the afdavit in the application for decision by default (for example
the
Form 6 – application for decision by default – minor debt).
Interstate service
If the respondent resides in another state or territory you will need to provide an additional notice to
the respondent, as required by the Service and Execution of Process Act 1992 (see also Practice
Direction 2 of 2014). The notice is available on the QCAT website at www.qcat.qld.gov.au.
Where to lodge your Afdavit of service
The Afdavit of service must be lodged in the QCAT registry where the application that started the
proceeding was lodged.
By post: QCAT, GPO Box 1639, Brisbane QLD 4001
If you are posting your original response and/or counter-application and copies to
QCAT, you need to include a stamped self-addressed A4 envelope with your material.
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.
For more information visit www.qcat.qld.gov.au or call 1300 753 228.
PART B DETAILS OF SERVICE
Refer to the Queensland Civil and Administrative Tribunal Rules 2009 and the tribunal’s practice
directions for service requirements available at www.qcat.qld.gov.au.
Insert your full name and residential or business address or place of employment.
If the entity served is not an individual then the correct name must be used. For example, a company
name, business name (regardless of whether it is registered) or a State agency name. For further
information you can refer to the tribunal’s factsheet How to identify and name parties in QCAT
available at www.qcat.qld.gov.au.
If you are serving an application for a minor debt claim you must deliver the copy to an entity
personally and in a way that complies with QCAT’s practice direction on service. Practice Directions
are available at www.qcat.qld.gov.au.
Instructions – Afdavit of service – page 1 of 2
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
SIGNATURE
Please sign in the presence of a person who is authorised by the Oaths Act 1867 to take an afdavit:
(a) a justice, commissioner for declarations or notary public under the law of Queensland, the
Commonwealth or another State,
(b) a lawyer,
(c) a conveyancer, or another person authorised to administer an oath, under the law of the
state, the Commonwealth or another state,
(d) if the afdavit is taken outside Australia — a person authorised to administer an oath under
the law of the place in which the afdavit is taken.
Each page must be signed in the presence of a qualied witness.
A qualied witness includes a lawyer, Justice of the Peace or a Commissioner for Declarations.
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 – Afdavit of service – page 2 of 2
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Form Number 9 (version 3): QCAT Afdavit of (Department of the Environment and Energy)

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Completed 1 February 2021

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