Form 4 - Termination Notice By Mutual Agreement
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4Manufactured homes
Form 4
Termination notice—by mutual agreement
Manufactured Homes (Residential Parks) Act 2003
This form is effective from 5 September 2014
Before signing this form, seek independent professional advice from a
solicitor, community legal service or financial adviser.
It is an offence under the Manufactured Homes (Residential Parks) Act 2003
(the Act) for a park owner or manager to coerce (try to force) or attempt to coerce
Warning
a home owner to terminate a site agreement. Significant penalties apply.
It is an offence under the Act for a park owner or manager to agree to
terminate a site agreement using this form before or on the same day as
entering into the site agreement. Significant penalties apply.
A home owner (or home owners) and the park owner/manager complete this form when both parties
agree to terminate the site agreement.
Instructions
After this form has been signed by both parties, the home owner/s must give the park owner/manager
vacant possession of the site on or before the agreed date.
Please complete this form in BLOCK letters. Attach extra pages if needed. Give all references to dates
as DD/MM/YYYY.
If you need help completing this form, please contact the Department of Housing and Public Works on
13 QGOV (13 74 68).
Part 1—Home owner (to be completed by home owner/s)
Home owner/s
Person 1
Name/s of home
Preferred title
Mr
Mrs
Ms
Miss Other
..............
(specify)
owner/s
First name ..................................... Last name ........................................
Person 2
Preferred title
Mr
Mrs
Ms
Miss Other
..............
(specify)
First name ..................................... Last name ........................................
Site and park
Park name .................................................................................................
Site number
.............................................................................
(if applicable)
Street name within park
...........................................................
(if applicable)
..................................................................................................................
Park address ..............................................................................................
..................................................................................................................
Suburb .............................................. State
Postcode
Manufactured Homes (Residential Parks) Act 2003 • Section 36 • Form 4 • V3 • September 2014
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