Your Name:
Are you:
Business Address:
Hearing Notes
Residential Tenancies Act 2010
Tribunal Record
File Number:
/
NCAT Tenancy Hearing Notes (December 2018)
Tenancy Agreement
Rent Increases - last 12 months
Termination Notice


Current Situation
Sworn / Affirmed
Date of Agreement:
Rent Amount:
Term of Agreement:
Bond Amount:
Bond Lodged?
Bond Paid Out?
$
payable on the
of each Week Fortnight Month
from to
$
Bond Number:
Yes No
Amount
$
Yes No
$
to Landlord
to Tenant
Date of Notice Date of Service Increased From Increased To Valid/Invalid
$
$
$
$
$
$
Date of Notice:
Date Sent:
Date Received:
Termination date on Notice:
Days in arrears on receipt:
By: Post Personal service Mailbox (s223)
Notice valid / invalid
Complies Yes / No
Landlord Agent Tenant
Note: Allow 7 working days if by post
Date signed:
Managing Agency Agreement:
Yes No
Premises vacant?
Rent paid to (and including):
Arrears claimed:
Total no of days in arrears:
Water usage claimed:
Yes No
$
$
Date vacated:
Date last payment
from to
inclusive
Daily rate:
$
from to inclusive
Tribunal Use Only
Member’s Name Member’s
Signature
Date Order Made
Premises Residential: Yes / No Hearing Notice Served: Yes / No
Agreement Regulated: Yes / No
Oral / Written
Application Received Within Time : Yes / No
(s88(4) before termination date)
(s83(2) Reg 22, 30 days after termination date)
Notice to Vacate valid: Yes / No
Appearance Tenant: Yes / No Appearance Respondent: Yes / No
REQUIREMENTS FOR TERMINATION NOTICE UNDER S.82 & 88
TERMINATION FOR BREACH - CIRCUMSTANCES OF THE CASE S.87(5)
1. Nature of the breach: …………………………………………………………………………………………………………….
2. Any previous breaches: ………………………………………………………………………………………………………….
3. Steps taken by tenant to remedy the breach: ………………………………………………………………………………...
4. Steps taken by the landlord about the breach: ………………………………………………………………………………..
5. Previous history of the tenancy: ………………………………………………………………………………………………..
Residential premises …………………………………………………………………………………………………………...
The termination and vacant possession date s.82(1), s.83(1) (not earlier than 14 days after the day on which
notice given)……………………………………………………………………………………………………………………..
The grounds, eg. rent unpaid for not less than 14 days before the notice given ……………………………………….
In writing …………………………………………………………………………………………………………………………
Signed by party giving notice …………………………………………………………………………………………………
Notice to tenant: that tenant is not required to vacate if tenant pays all rent owing or enters into and fully complies
with an agreed payment plan (s88) …………………………………………………………………………………………...
Other grounds …………………………………………………………………………………………………………………..
Tick if agent
Has the landlord sought a finding that tenant has frequently failed to pay rent? Yes / No
Has tenant paid all rent owing? Yes / No
Has tenant entered into agreed payment plan? Yes / No
Has tenant complied with agreed payment plan? Yes / No
Has tenant frequently failed to pay rent owing? Yes / No
Are you making a finding under s.89(5)? Yes / No
S.89(5) FINDING
TERMINATION OF SOCIAL HOUSING TENANCY S.154E
1. Effect of tenancy on neighbouring residents or others: ………………………………………………………………...……
2. Likelihood that neighbours or others will suffer serious adverse effects if tenancy not terminated: …………………….
3. Landlord’s responsibility to other tenants: ……………………………………………………………………………………..
4. History of current/any prior SH tenancy with same/different landlord: ……………………………………………………..
5. Whether tenant is/has been in breach of Tribunal order: ……………………………………………………………………