Home Application forms Application for help to resolve a Commercial Tenancy Relief Scheme rent relief dispute Application formsApplication for help to resolve a Commercial Tenancy Relief Scheme rent relief dispute The Victorian Small Business Commission (VSBC) is providing free and impartial mediation to commercial tenants and landlords to help resolve rent relief disputes in response to coronavirus (COVID-19).This includes disputes under the Victorian Government’s Commercial Tenancy Relief Scheme (the Scheme) where the dispute relates to a tenant’s written rent relief request that was made:from 29 September 2020 to 28 March 2021 and complies with the Scheme’s requirements – please apply using this form from 29 March 2020 to 28 September 2020 and complies with the Scheme’s requirements – please apply using our retail leases dispute form.For rent relief disputes before 28 March 2021 where the Scheme doesn’t apply and parties are wanting help to resolve the matter, either the tenant or landlord can apply for mediation using our retail leases dispute form. This form can also be used for rent relief disputes after 28 March 2021.Because the VSBC doesn’t provide legal or other professional advice, you should consider getting this advice from a suitably qualified and experienced person (e.g. a lawyer, accountant). Doing so might be helpful and important before and during mediation.The details you provide in this form might be sent to the other party. Sending us this form means you agree to this. If you intend to have someone else represent you at mediation, please read our web page on authority to participate in mediation.If you have any questions about how we can help, you can call us on 13 8722 or 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, see our responses to frequently asked questions.Application for help to resolve a rent relief dispute – Word versionApplication for help to resolve a rent relief dispute – filled-in exampleApplicant 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 (the name of the person, business or company applying for help to resolve the dispute), please provide the names and addresses of these applicants and their representatives by clicking ‘Add another applicant’ at the end of this section.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.Have 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):Your contact email*This will be the primary email we use if we need to contact you. 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?*YesNoWere 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?*You can compare GST turnover for the quarter ending 31 December 2020 (October, November and December 2020) with the corresponding period 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 Applicant typeBusiness or companyNot a business or companyBusiness/company name or applicant name*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)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) Add another applicantRemove this applicantIf there is more than one applicant (person, business or company applying for help to resolve the dispute), please provide the names and addresses of these applicants and their representatives by clicking the above button.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 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 (the other party – the person, business or company that the applicant is in a dispute with), please provide the names and addresses of these respondents and their representatives by clicking ‘Add another respondent’ at the end of this section. 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. Respondent: LandlordIf there is more than one respondent (the other party – the person, business or company that the applicant is in a dispute with), please provide the names and addresses of these respondents and their representatives by clicking ‘Add another respondent’ at the end of this section. 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. Respondent: TenantRespondent typeBusiness or companyNot a business or companyBusiness/company name or respondent name*Business or company ACN or ABN (if this is known)Name of the person who is the contact for the respondent (if a business or company)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) Add another respondentRemove this respondentIf there is more than one respondent (the other party – the person, business or company that the applicant is in a dispute with), please provide the names and addresses of these respondents and their representatives by clicking the above button.Dispute detailsDispute information*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*Privacy statement* I have read and accept the VSBC’s privacy statementBefore you submit this application form, we would appreciate your feedback I would like to provide feedbackFeedbackHow 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?CommentsThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.