File Number

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	ACT CIVIL AND ADMINISTRATIVE TRIBUNAL

APPLICATION – 
UNIT TITLES ACT 2001*

	*for applications about disputes under the Unit Titles Act 2001		

APPLICANT’S DETAILS	
Name	 	
Status (what are you)	  Owner           Occupier         Owner’s Corporation         Executive Committee	
Address line 1	
 	
Address line 2	
 	
Telephone	                                                                    Fax:                                       
Email:	
APPLICANT’S REPRESENTATIVES DETAILS (IF ANY)	
Name

Address line 1	
 	
Address line 2	
 	
Telephone	                                                                    Fax:                                       
Email:	
RESPONDENT’S DETAILS	
Name	 	
Status (what is the respondent )	Owner     Occupier     Owner’s Corporation       Manager      Member Executive 

Service Contractor 	
Address line 1	
 	
Address line 2	
 	
Telephone	                                                                    Fax:                                       
Email:	
What Orders or Declarations do you seek(use an attachment if insufficient space) 	

	

	

	

Reasons for your application and allegations relied on (use an attachment if insufficient space. Consider providing a summary only and putting details in an accompanying affidavit or statement with attached relevant documents).

	

	

	

	

	

	

	

	

	

	

	

	
Applicant’s signature		Date