Form 3	Small Claims Court—application under Common Boundaries Act 1981, section 6 (1)
Common Boundaries Act 1981

In the Small Claims Court of the Australian Capital Territory

Application No		of (year) (Court to complete)

(name)
Applicant

(name)
Respondent

To the Registrar:
The applicant applies for a determination under the Common Boundaries Act 1981, section 7 (3).
Applicant
Full name:
Address:
(if the applicant is represented by another person)
Representative’s full name:
Representative’s address:
Respondent
Respondent’s name:
Respondent’s address:
Details of application
1	The applicant occupies land situated at (address) being block (number), section (number), division of (name of division) (the applicant’s land).
2	The respondent occupies land situated at (address), being block (number), section (number), division of (name of division) (the respondent’s land).
3	The applicant proposes that the fence separating the applicant’s land and the respondent’s land be *[repaired/replaced].  Particulars of the proposed *[repair/replacement] of the fence are as follows:
	(set out details of proposed repair or replacement)
4	The cost of the proposed *[repair/replacement] of the fence is $ (amount).  The applicant proposes that the respondent contribute $ (amount).
5	On (date), the applicant gave the respondent a notice in writing requesting the respondent to discuss the *[repair/replacement] of the fence between the applicant’s land and the respondent’s land.
*6	The respondent has refused to join in the *[repair/replacement] of the fence.
*6	The applicant and respondent have not been able to agree upon the following matters:
	(set out the matters that cannot be agreed)

Date:

(signature of applicant or applicant’s representative)
(name of applicant or applicant’s representative)
*omit if, or whichever is, inapplicable