Home Application forms Application for help to resolve a dispute about rent relief in response to coronavirus Application formsApplication for help to resolve a dispute about rent relief in response to coronavirus For disputes about temporary leasing arrangements under the Victorian Government’s Commercial Tenancy Relief Scheme (the Scheme) Before completing this application form, you might want to consider getting legal advice or calling the Victorian Small Business Commission (VSBC) on 13 8722 or TTY 03 9651 7596. The details you provide in this form might be sent to the other party. Sending us this form means you agree to this.There is no cost for the help we provide by phone, email or for mediation to resolve disputes about rent relief in response to coronavirus (COVID-19).If you would like to speak with us in your language about how we can help, call us through the Translating and Interpreting Service.Please provide as much of the below information as you can to help us assist you. For further help in completing this form, see our responses to frequently asked questions.Applicant detailsHave you contacted us before about a dispute?*YesNoIs this an application for further rent relief?YesNoIf this is related to a previous VSBC rent relief dispute, please state the VSBC reference number (see the subject line of the VSBC correspondence):Are you a tenant or landlord?TenantLandlordHow many people do you employ?*0 employees1-4 employees5-19 employees20-199 employees200+ employeesIs the aggregate turnover of your business less than $50 million?YesNoAre you taking part in the Commonwealth Government’s JobKeeper scheme?*YesNoPlease attach the following evidence:*- your Business Registration for JobKeeper Wage Subsidy receipt number issued by the ATO (you can request this from the ATO’s call centre) and - a copy of your most recent notice to the ATO under the JobKeeper Rules. Drop files here or What per cent reduction in turnover have you experienced because of coronavirus?*Turnover is calculated using the actual decline in turnover test. You can compare GST turnover for the quarter ending 30 September 2020 (July, August and September 2020) with the corresponding quarter in 2019. To work out actual turnover, tenants need to use a cash or accruals basis, though they must use the same method for both quarters (2020 and 2019).Please attach one of the following:*- extracts from your accounting records or - your most recent business activity statement(s) for the relevant turnover period or - your account statements (issued by an authorised deposit-taking institution e.g. a bank) or - a statement prepared by a practising accountant.Please provide the following:- all other evidence you have provided to your landlord, including your written request for rent relief and - all relevant correspondence and other materials sent between you and your landlord after you requested rent relief. Drop files here or Tenancy detailsType of lease*RetailCommercialOtherPlease specify other type of lease:Please attach a copy of your lease*Tenant’s name on the leaseBusiness or trading name (if this applies)Shopping centre name (if this applies)Street address including shop number(s) (if this applies), and suburb/city/town and state*PostcodeWhat is the premises used for?*What is the start date of the lease or lease extension?* Date Format: MM slash DD slash YYYY Applicant detailsThe applicant is the name of the person, business or company applying for help to resolve the dispute.If there is more than one applicant, please provide the names and addresses of these applicants and their representatives using copies of the attachment at the end of this form.If the tenant or landlord is represented by an agent or solicitor, please provide the names, addresses and telephone numbers for BOTH the tenant or landlord AND agent or solicitor. Is the applicant a landlord or tenant?LandlordTenantApplicant typeBusiness or companyNot a business or companyBusiness or company name*Business or company ACN or ABN (if this is known)Name of the person who is the contact for the business or company*Name*Street or postal address* Street address Address line 2 City State Postcode Phone*Email (if the applicant has one) Name of the applicant’s representative (e.g. solicitor or estate agent)Street or postal address Street address Address line 2 City State Postcode PhoneEmail (if the representative has one) Respondent detailsThe respondent is the name of the other party (the person, business or company that the applicant is in a dispute with).If there is more than one respondent, please provide the names and addresses of these respondents and their representatives using copies of the attachment at the end of this form.If the tenant or landlord is represented by an agent or solicitor, please provide the names, addresses and telephone numbers for BOTH the tenant or landlord AND the agent or solicitor. Is the respondent a landlord or tenant?LandlordTenantRespondent typeBusiness or companyNot a business or companyBusiness or company name*Business or company ACN or ABN (if this is known)Name of the person who is the contact for the business or company*Name*Street or postal address* Street address Address line 2 City State Postcode Phone*Email (if the respondent has one) Name of the respondent’s representative (e.g. solicitor or estate agent)Street or postal address Street address Address line 2 City State Postcode PhoneEmail (if the representative has one) Dispute details*Please provide a brief description of your dispute. If you would like to provide additional documents that relate to the dispute, please attach these below.Dispute documents Drop files here or Rent and rent relief claimed*Before you submit this application form, we would appreciate your feedbackHow did you find out about us?Presentation delivered by the VSBCYour lawyerYour accountantBusiness networkIndustry/business associationYour local councilOnline search taking you to our websiteSocial mediaMedia (print/online/radio e.g. news story)OtherPlease specify other:How easy was it to find this form on our website?Very easyEasyAverageDifficultVery difficultHow easy was it to complete this form?Very easyEasyAverageDifficultVery difficultDo you have any other feedback about this form?AttachmentPlease use this attachment if there is more than one applicant or respondent. Please provide the names and addresses of the other applicants or respondents and their representatives.If the tenant or landlord is represented by an agent or solicitor, please provide the names, addresses and telephone numbers for BOTH the tenant or landlord AND the agent or solicitor. Information relating toApplicantRespondentApplicant / respondent typeBusiness or companyNot a business or companyBusiness or company name (if a business or company)Business or company ACN or ABN (if this is known)Name of the person who is the contact for the applicant (if a business or company)Name (if not a business or company)Street or postal address Street address Address line 2 City State Postcode PhoneEmail (if the applicant has one) Name of the applicant’s representative (e.g. solicitor or estate agent)Street or postal address Street address Address line 2 City State Postcode PhoneEmail (if the representative has one) Add another applicant or respondentRemove this applicant / respondentEmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.