RESIDENTIAL TENANCIES LIST

Victorian Civil and Administrative Tribunal Rules 2008 Rule 7A 07(11) 7A.09(5)

In the matter of an application under section 414 of the Residential Tenancies Act 1997 for the payment of bond for rent arrears where the tenant has vacated and the current address of the tenant is unknown to the landlord.

VCAT Reference Number R______

______Landlord

and

______Tenant

AFFIDAVIT IN SUPPORT OF REQUEST FOR DETERMINATION

I, ______of

Insert full name

______

Insert address

In the State of Victoria, ______,

insert occupation

MAKE OATH AND SAY THAT:

1.I am the landlord of the rented premises known as ______

______

OR

1.I am the Agent for the landlord of the rented premises known as ______

______

and I am authorised by the landlord to act for and on behalf of the landlord in this matter.

2.The name of the landlord is as specified above and the address of the landlord is

______

3.The name of the tenant is as specified above.

4.The following inquiries have been made by the landlord as to the whereabouts of the tenant: ______

______

5.On the _____day of ______201 at ______am/pm I gave the tenant a copy of the application by sending it by registered post from the Post Office at ______

and addressed to the tenant at ______

______

6.Now produced and shown to me and marked ‘A’ is a true copy of the registered post receipt number ______.

7.The bond is in the amount of $______, of which the sum of $______

Was paid by the tenant *and the sum of $______was paid on behalf of the tenant by the Director of Housing.

*Delete if DoH did not provide whole or part of bond

8.Rent is $______per ______and is paid to and including _____/_____/_____. The tenant *vacated/abandoned the rented premises on _____/_____/_____ and the rent owing by the tenant to the landlord at this date was $______, which is ______days’ rent at $______per day. The sum of $______, is an amount paid on account or part of a day’s’ rent and has been taken into consideration when calculating the total sum owed by the tenant.

9.I request the making of a determination of the amount of rent owing to the landlord by the tenant ; and

*a determination directing the Authority pay out an amount of bond to or on account of the landlord in respect of the rent owing. *delete as required.

Sworn at ______

On the ______day of ______20__

Deponent’s signature:______

(person making affidavit to sign here & first page)

Before me (signature)______

______

______

______

______

(print name, address, qualification and sign first page)

Persons qualified to take Affidavits in Victoria include:

The holder of an office in the public service of Victoria that is prescribed as an office of which the holder may receive affidavits

A member of the police force of or above the rank of sergeant or for the time being in charge of a police station

A solicitor

A Justice of the Peace or a Bail Justice

The Registrar or a Deputy Registrar

______Victorian Civil and Administrative Tribunal

55 King Street Melbourne VIC 3000Website 1300 01 8228

GPO Box 5408 Melbourne VIC (1300 01 VCAT)

Ausdoc DX 210576 Melbourne