Breach Form

Form 11 Internet: www.rta.qld.gov.au Notice to Remedy Breach Residential Tenancies Act 1994 (Sections 192) 3 Name and Address of Party in Breach Who is this Notice to Remedy Breach being given to? Lessor Agent Tenant/s Name/s Purpose of this form—This form is used during the tenancy where either the tenants or the lessor/agent claim that there has been a ‘breach’ of one (or a number) of terms of the residential tenancy agreement. Form completed—and given by either the tenants or the lessor/agent to the party who is ‘in breach’. If you receive this form either as a tenant or a lessor/agent—it means that the other party is letting you know there is a problem or dispute, and you need to take action to rectify the situation within a certain time. If you do not agree there has been a breach, you should lodge a Dispute Resolution Request (Form 16) with RTA by the date in 5 below. For parties who cannot resolve a tenancy dispute after a Notice to Remedy Breach has been issued, the RTA offers a Dispute Resolution Service. For further information read the Information Statement you received at the start of your tenancy or contact the RTA. 4 What is the breach of the agreement which is the reason for this notice? Please Use Block Letters 1 Who is serving this Notice to Remedy Breach? Lessor Agent Tenant/s Name/s 5 By what date must the breach of the agreement be remedied? (There are minimum times which must be allowed.) Date / / 6 2 Address of the rental premises Date Issued / / 7 Postcode Signature of Party Giving the Notice DO NOT SEND THIS FORM TO RTA - Please Retain a Copy for your Records Form 11 – Ev6 August 2003

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