Name *

First Name

Last Name

Property Address: *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Type of Modification *

General (Minor) Modification

Special Modification

Definition Part 5AA of the Residential Tenancies Act 1997 *

Definition Part 5AA of the Residential Tenancies Act 1997 Minor Modification to the premises under a residential tenancy agreement, means a modification that can be removed or undone so that the premises are restored to substantially the same condition as the premises were in at the commencement of the agreement, fair wear and tear accepted. Special Modification means (a) a minor modification; or (b) a modification for 1 of the following reasons: (i) the safety of the tenant or other people of the premises; (ii) on written recommendation of a health practitioner – to assist a tenant in relation to the tenants disability; (iii) to allow access to the telecommunications services; (iv) the security of the premises, or the tenant or other people on the premises; (v) any other prescribed reason

I have read and I acknowledge the above clause

Important Information

1. Any approved modifications if approved are at the tenants’ expense, unless otherwise agreed in writing 2. If approved, the lessor may impose conditions on the modifications, such as restoration at the end of the tenancy and works to be completed by a qualified tradesperson 3. If a special modification is refused, the lessor is required to lodge an application with ACAT within 14 days 4. If a general (minor) modification is refused, the tenant is required to lodge an application with ACAT ACKNOWLEDGEMENT OF THE APPLICATION BY THE APPLICANT.

By submitting this form it is acknowledged that, I have read & understood the above information and that by submitting this form it is NOT an approval to make a modification to the property at this stage