Residential Property Tribunal Service - PH3 Form by lI3t1Y


									 Residential Property Tribunal Service                                                         Ref no. (for office use only)

                                                                                                 Application Form
                                        Section 4 of the Mobile Homes Act 1983 (as amended)
                                           Application by occupier of a Park Home or a Park Home site
                                          owner to a residential property tribunal for a determination of
                                             any question arising under the Mobile Homes Act 1983 or
                                                                           agreement to which it applies

 It is important that you read the notes below carefully before you complete this form.
 Most disputes arising in respect of the occupation of a park home on a protected site by virtue an agreement between
 the home owner and the site owner are covered by a specific application form depending on the nature of the dispute.
 By contrast, this is the correct form to use if, by agreement with the site owner, you are an occupier of a park home or
 you are party to such an agreement as a site owner and you want a residential property tribunal to determine any other
 question arising under that agreement or under the Mobile Homes Act 1983. The other party to your application is
 known as the Respondent.
 A fee is payable for this application. (See Annex 1 for fees and exemptions). Please send your completed
 application form and fee (if applicable), together with a copy of your agreement (if in writing) and any other
 documents specified below to the appropriate Rent Assessment Panel. (See Annex 2 to this form for Panel
 addresses). If and when further evidence is needed you will be asked to send it separately.

 If you have any questions about how to fill in this form or the procedures the tribunal will use, please call the
 Residential Property Tribunal Service on 0845 600 3178.


   Address of Site:

   Is the site a local authority (including county council) site providing accommodation for gypsies and travellers?
   YES                NO


  Address of premises to which agreement to occupy relates:

  Address for correspondence (if different):

  Telephone: Day:                              Evening:                            Mobile:
  Email address:                                                                   Fax:

FORM PH3 (10/11)
 2. DETAILS OF APPLICANT (continued)

   Name and address and details of agent (if relevant):

Where details of an agent have been given, all correspondence and communications will be with them until the Tribunal is
notified that they are no longer acting.



   Address for correspondence (if different)

   Telephone: Day:                             Evening:                           Mobile:
   Email address (if known)                                                       Fax:
   Name and address and details of agent (if relevant):


   (a) Date of Agreement:

   (b) Parties to Agreement:

   (c) Date of any statement received
   or given:

   Please enclose:
   A copy of any statement you have received or given

FORM PH3 (10/11)
   Please set out below (a) the question(s) that you would like the tribunal to determine (b) the order(s) that you are
   seeking from the tribunal and (c) a brief explanation of why you believe the Tribunal should make the
   determination(s) and order(s) requested. (Please continue or set out on a separate sheet if necessary).

   It may be possible for your application to be dealt with entirely on the basis of written representations and documents
   and without the need for parties to attend and make oral representations. (“A paper determination”).
   Please let us know if you would be happy for the case to be dealt with by way of paper           YES            NO
   NB: Even if you have asked for a paper determination the Tribunal may decide that a hearing is necessary.
   You can also ask for a hearing at any time before the determination is made. Please go on to complete the
   remainder of this form on the assumption that a hearing will be held.

   If there are any dates or days we must avoid during the next three months (either for your convenience or the
   convenience of any witness or expert you may wish to call) please list them here.
   Dates on which you will NOT be available:

   Please provide details of any special requirements you or anyone who will be coming with you may have (e.g. the
   use of a wheelchair and/or the presence of a translator):

 In London, cases are usually heard in Alfred Place which is fully wheelchair accessible. Elsewhere, hearings are held in
 local venues which are not all so accessible and the Clerks will find it useful to know if you or anyone you want to come
 to the hearing with you has any special requirements of this kind.

FORM PH3 (10/11)
   Please provide the following documents and
   tick box as appropriate:
    (a) a copy of the agreement
    (b) any relevant correspondence that the applicant has given or received in connection with the
    question to be determined.

 Please check that :
            You have completed this form fully. The Tribunal will not process your application until this has been done
             and it has both a copy of the required documents and the fee (if applicable).
            A copy of the required documents is enclosed.
            A crossed cheque or postal order for the fee (if applicable) is enclosed. Please put your name and address
             on the back of any cheque you send.
 DO NOT send cash under any circumstances. Cash payment will not be accepted and any application
 accompanied by cash will be returned to the applicant.
 Fees should be paid either by crossed cheque made payable to, or a postal order drawn in favour of the HM
 Courts and Tribunal Service.

 I believe that the facts stated in this application are true.

 Signed:                                                               Dated:

FORM PH3 (10/11)
 ANNEX 1: Fees payable for applications to the tribunal in respect of applications under the Mobile
 Homes Act 1983 (“the 1983 Act”).
 1. A fee of £150 is payable for an application to a tribunal under paragraph 28(1)(h) of Chapter 2, or paragraph 26(1)(h)
    of Chapter 4, of part 1 of Schedule 1 to the 1983 Act (qualifying residents’ association to be acknowledged by owner
    of protected site).

 2. A fee is payable for an application to a tribunal under the following provisions of the `1983 Act.

          (a) section 2(2) (terms concerning matters mentioned in Part 2 of Schedule 1 to the 1983 Act to be implied in

          (b) section 2(3) (variation or deletion of express terms in agreement);

          (c) section 4 (determination of any question arising under the 1983 Act or any agreement to which the 1983 Act

          (d) paragraphs 4, 5 or 5A2 of Chapter 2, or paragraphs 4, 5 or 6(1) of Chapter 4, of part 1 of Schedule 1 to the
              1983 Act (termination by owner);
         (e) paragraph 10(1) of Chapter 2, or paragraph 8(1) of Chapter 4, of part 1 of Schedule 1 to the 1983 Act (site
             owner application as to re-siting of mobile home).

 3. The fee payable for each application in 2 above is detailed in the table below;

      Number of references                                              Application Fee
      where the application contains one reference                            £150
      where the application contains two references                           £250
      where the application contains three or four references                 £400
      where the application contains five or more references                  £500

 4. For the purposes of 3 above the number of references contained in an application is

          (a) in the case of an application made in respect of one pitch or mobile home, the number of provisions of the
              1983 Act to which that application relates; and
          (b) in the case of an application made in respect of more than one pitch or mobile home, the number of pitches
              or mobile homes to which the application relates.

 Transferred Applications
 5. No fee is payable to a tribunal , in any case, in relation to an application made under the Mobile Homes Act 1983 that
    has been transferred from a court to a tribunal.

 Waiver of Fees
 6. No fee is payable in any case where on the date that the application is made the applicant or that person’s partner is
    in receipt of
        Income Support
        Housing Benefit
        Income Based Job Seeker’s Allowance
        Income-Related Employment and Support Allowance
        A Working Tax Credit where:
              either that Credit includes a disability element or severe disability element (or both) or it is combined
                with child tax credit and
              the gross annual income used to calculate the Working Tax Credit is £16,190 or less
    A guarantee credit under the State Pensions Credit Act 2002
 7. If you wish to claim a waiver of fees you must complete another form available from the Panel office (Form RPT2).
     The waiver form will not be copied to other parties in the proceedings.

FORM PH3 (10/11)
 ANNEX 2: Addresses of RPTS Panel Offices
   First Floor, 5 New York Street,                            Telephone: 0845 100 2614 or 0161 237 9491
   Manchester M1 4JB                                          Fax: 0161 237 3656

   This office covers the following Metropolitan districts: Barnsley, Bolton, Bradford, Bury, Calderdale, Doncaster,
   Gateshead, Kirklees, Knowsley, Leeds, Liverpool, Manchester, Newcastle-upon-Tyne, Oldham, Rochdale,
   Rotherham, St. Helens, Salford, Sefton, Sheffield, Stockport, Sunderland, Tameside, Trafford, Tyneside (North &
   South), Wakefield, Wigan and Wirral.
   It also covers the following unitary authorities: Hartlepool, Middlesborough, Redcar and Cleveland, Darlington,
   Halton, Blackburn with Darwen, Blackpool, Kingston-upon-Hull, East Riding of Yorkshire, Northeast Lincolnshire,
   North Lincolnshire, Stockton-on-Tees, Warrington and York.
   It also covers the following Counties: Cheshire, Cumbria, Durham, Lancashire, and Lincolnshire.

   2     Floor, Louisa House, 92-93 Edward Street,             Telephone: 0845 100 2615 or 0121 236 7837
   Birmingham B1 2RA                                           Fax: 0121 236 9337

   This office covers the following Metropolitan districts: Birmingham, Coventry, Dudley, Sandwell, Solihull,
   Walsall and Wolverhampton.
   It also covers the following unitary authorities: Derby, Leicester, Rutland, Nottingham, Herefordshire, Telford and
   Wrekin and Stoke-on-Trent.
   It also covers the following Counties: Derbyshire, Leicestershire, Nottinghamshire, Shropshire, Staffordshire,
   Warwickshire and Worcestershire.

   Unit C4, Quern House, Mill Court                            Telephone: 0845 100 2616 or 0122 384 1524
   Great Shelford, Cambridge CB22 5LD                          Fax: 0122 384 3224

   This office covers the following unitary authorities: Bracknell Forest, West Berkshire, Reading, Slough, Windsor
   and Maidenhead, Wokingham, Luton, Peterborough, Milton Keynes, Southend-on-Sea and Thurrock.
   It also covers the following Counties: Bedfordshire, Berkshire, Buckinghamshire, Cambridgeshire, Essex,
   Hertfordshire, Norfolk, Northamptonshire, Oxfordshire and Suffolk.

   1 Floor, 1 Market Avenue,                                   Telephone: 0845 100 2617 or 0124 377 9394
   Chichester, PO19 1JU                                        Fax: 0124 377 9389

   This office covers the following unitary authorities: Bath and Northeast Somerset, Bristol, North Somerset,
   South Gloucestershire, Bournemouth, Plymouth, Torbay, Poole, Swindon, Medway, Brighton and Hove, Portsmouth,
   Southampton and the Isle of Wight.
   It also covers the following Counties: Cornwall and the Isles of Scilly, Devon, Dorset, East Sussex,
   Gloucestershire, Hampshire, Kent, Somerset, Surrey, West Sussex and Wiltshire.

   10 Alfred Place,                                            Telephone: 020 7446 7700
   London WC1E 7LR                                             Fax: 020 7637 1250

   This office covers all the London boroughs.

FORM PH3 (10/11)

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