Form 16 - Application To Vary Or Set Aside Order
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1MAGISTRATES
RESIDENTIAL TENANCIES ACT 1987 (WA)
Case number:
COURT:
Section 17
………………….....……..
APPLICATION TO VARY OR SET
REGISTRY
Date lodged:
ASIDE ORDER
PH:
FORM 16
FAX:
Method of service:
Name:
APPLICANT(S)
Tick [ ] a box
Address:
Postcode:
Lessor
Tenant
RESPONDENT(S)
Name:
Tick [ ] a box
Address:
Postcode:
Lessor
Tenant
On the _______ day of _________________ 20_______ an order was made by the Court in my absence.
I hereby make application to have that order set aside/varied for the following reasons
:
(give details)
Signature of applicant
Date
Take notice that this application has been set down for hearing in the Magistrates Court at:
___________________________________________________________________________________
on________________ day, the ____________ day of _____________________________ 20 ________
at ________________ am/pm.
Registrar
Date
Court Seal
To the Lessor
(name and address)
To the tenant
(name and address)
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