Schedule 1 - Application For Disposal Of Bond Money (Form 6)
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RESIDENTIAL TENANCIES ACT 1987 (WA)
Case number:
MAGISTRATES COURT:
Schedule 1
PERTH REGISTRY
APPLICATION FOR DISPOSAL OF
501 HAY STREET
Date lodged:
PERTH WA 6000
BOND MONEY
PH: 9425 2222
FAX: 9425 2777
FORM 6
Name:
APPLICANT
Tick [] a box
Address:
Postcode:
Lessor
Tenant
Name:
RESPONDENT
Tick [] a box
Address:
Postcode:
Lessor
Tenant
Address of rented premises:
I request that the bond amount of $
held by
at
be disbursed
as follows:
(1) The sum of $
to be paid to
(2) The sum of $
to be paid to
Date tenancy commenced
/
/
Weekly rental $
Date tenancy terminated
/
/
Date rental paid to
/
/
The reason this request is made is as follows:
(Description of claims and amounts of each claim in dollar value)
To: Respondent
UNLESS YOU NOTIFY THE COURT WITHIN SEVEN DAYS AFTER YOU RECEIVE THIS
APPLICATION THAT YOU INTEND TO DISPUTE THIS REQUEST FOR PAYMENT, THE
COURT MAY ORDER THAT THE BOND MONEY BE PAID IN ACCORDANCE WITH THE
APPLICANT’S REQUEST.
Signature of applicant
Date
Registrar
Date
L520
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