Forms for mediation

The following forms relate to farmer and creditor-initiated mediation under the Farm Debt Mediation Act 2011.

Forms relating to creditor-initiated mediation

Form 1: Notice of availability of mediation (section 8 notice from the creditor to the farmer)

N.B. along with form 1, the creditor must also send the farmer:

• a copy of forms 2 and 6 to allow the farmer to accept or decline the offer of mediation
• a copy of the Victorian Small Business Commission’s (VSBC) Farm debt mediation fact sheet and Guide to mediation.

Form 2: Farmer accepts creditor offer of mediation (section 9 notice from the farmer to the creditor)

Form 3: Notice to the VSBC that creditor-initiated mediation is required – please complete via our help portal (if you would like this form in an accessible Word version, contact us)

N.B. along with form 3, the creditor also sends the VSBC copies of forms 1 and 2.

Form 6: Notice of decision not to mediate (section 19(1)(b) notice from the farmer to the creditor)

Forms relating to farmer-initiated mediation

Form 7: Farmer request for farmer-initiated mediation concerning farm debt (section 9(1)(b) notice from the farmer to the creditor)

N.B. along with form 7, the farmer also sends the creditor a copy of form 8 to allow the creditor to accept the offer of mediation.

Form 8: Creditor agrees or refuses to enter into farmer-initiated mediation (section 10(1) notice from the creditor to the farmer)

Form 9: Notice to the VSBC that farmer-initiated mediation is required – please complete via our help portal (if you would like this form in an accessible Word version, contact us)

N.B. along with form 9, the creditor also sends the VSBC copies of forms 7 and 8.

Farmer request for a prohibition certificate

Form 10: Farmer request for prohibition certificate – please complete via our help portal (learn more about prohibition certificates, and if you would like this form in an accessible Word version, contact us)

Creditor request for an exemption certificate

Form 4: Creditor request for exemption certificate – please complete via our help portal (learn more about exemption certificates, and if you would like this form in an accessible Word version, contact us)

Contact

For all farm debt mediation requests and notices, farmers and creditors must use the forms on this page, which have been approved by the VSBC.

For general information about the forms or queries about farm debt mediation, contact us by calling 1800 878 964 or emailing enquiries@vsbc.vic.gov.au.

More information

For more information:

• see our farm debt mediation process, FAQs and information on important changes to the Farm Debt Mediation Act 2011
• access support and information for farmers and information for creditors
• contact us.

Related information