B
Form 603

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BOND LODGEMENT FORM
PRIVACY COLLECTION STATEMENT (PRIVACY ACT 1988 (C’WLTH)) OVERLEAF

1. AMOUNT OF BOND
Amount of Bond	Weekly Rent	Date of Tenancy Commencement	
     	     	     	

2. RENTED PREMISES 
Unit No.	Street No.	Street & Complex Name	Suburb	Postcode	
     	     	     	     	     	
Number of Bedrooms	Dwelling Type	
     	                   Separate House                             Townhouse/Semi-Detached                  Flat/Unit	
3. TENANT/S
LIST ONLY THE TENANTS WHO CONTRIBUTED TO THE BOND. DO NOT LIST CHILDREN, OR  PERSONS WITH NO ENTITLEMENT TO THE BOND.
Title	Family Name	Given Name/s	Phone Work/Mobile	Signature	
     	     	     	     		
     	     	     	     		
     	     	     	     		
     	     	     	     		
Date Signed        	
4. LESSOR
Family Name	     	Given Name/s	     	
Family Name	     	Given Name/s	     	
Address	     	
Phone Work	     	Phone Home	     	Phone Mobile	     	
Signature/s	Date Signed        	

5. MANAGING AGENT
Name of Agent	     	
Address	     	
Phone No.	     	Fax No.	     	
Signature/s	

For contact details for the Office of Rental Bonds, please call 6207 1178 or go to www.rgo.act.gov.au
PAYMENT DETAILS
If you are applying by mail and payment is by credit card please complete the details below.  If you are using another person’s credit card, the cardholder must also provide written consent and identification before the application will be processed.  Payment may be made by cash, credit card, EFTPOS, money order or cheque, all cheques and money orders should be made payable to the Registrar-General.  Applications paid by personal cheque will be held for 7-10 working days for the cheque to clear.	

 Mastercard	 Visa Card	Amount	$	
																						
Card Number																					Expiry Date 	   __ __ /  __ __	
	
Name of Cardholder		Signature of Cardholder		

INSTRUCTIONS FOR COMPLETION

N.B.  PERSONS PAYING BY PERSONAL CHEQUE SHOULD NOTE THAT A BOND IS NOT DEPOSITED UNTIL THE CHEQUE HAS BEEN CLEARED

1.	Alterations should not be made by erasure, but by scoring through with a pen and the words substituted, written above then verified by signatures in the margin.   
2.	Typewriting and handwriting should be clear, legible and in permanent black ink.
3.	List only persons who have contributed to the bond. DO NOT list children, or persons with no rights to the bond.
4.	All residential bonds must be lodged with the ACT Office of Rental Bonds. Lessors are required to lodge a rental bond within 10 working days of receipt. A penalty may apply under the Residential Tenancies Act 1997 if a rental bond is not lodged.
5.	Refunds are made by way of a ‘Not Negotiable’ cheque or Electronic Funds Transfer.
6.	To avoid unnecessary delays please ensure that the form is completed correctly.
7.	All persons listed on the Bond Lodgement form must sign in the spaces provided in Items 3, 4 &  5 of the form. The signatures will be used for comparison when a claim for refund of bond is lodged. If a third party is paying the bond on behalf of the tenant/s, and the third party is eligible for the refund at the end of the tenancy, then the third party should be listed as the tenant (e.g.: where Embassies/High Commissions pay the bond on behalf of the tenant/s – the Embassy/High Commission should be listed as the tenant.)
8.	The maximum amount of bond that can be charged is equivalent to 4 weeks rent. The lessor/agent must provide a receipt to the tenant/s as proof of payment.
9.	Bonds paid by personal cheque will not be refunded less than 30 days from the date of lodgement. 
10.	Please make cheques payable to the ‘ACT Office of Rental Bonds’.
11.	ACT Office of Rental Bonds are unable to accept third party cheques.
12.	NEVER SIGN A BLANK FORM especially where item 1 is not completed.
13.	More information on rental bonds can be found in the Office of Fair Trading “The Renting Book” or at www.fairtrading.act.gov.au.

At the time a bond is lodged it is assumed that if there is more than one party to the bond, the bond is attributed in equal shares. If this is not the case, the ORB will require a signed statement from the parties indicating the distribution of the bond at the time the refund is claimed.

OFFICE HOURS	LOCATION	
9.00am to 4.30pm Monday to Friday		255 Canberra Avenue, Fyshwick   ACT   2609
	
POSTAL ADDRESS	CONTACT NUMBERS	
PO Box 225  CIVIC SQUARE ACT 2608	Phone (02) 6207 1178            Fax (02) 6207 1181	
PRIVACY STATEMENT

The collection of information by this form is authorised by the Residential Tenancies Act 1997, and may be used by the Department of Justice and Community Safety for purposes authorised or permitted by the Act.  It will be treated confidentially and will only be made available to other Departments in circumstances relating to law enforcement.  Non-identifying information is regularly released to the Real Estate Institute of Australia.