Tenancies Branch

Level 1, 91-97 Grenfell Street, ADELAIDE SA 5000 Office Hours: 8.30 am - 5 pm SECURITY BOND NO (IF KNOWN)
GPO Box 965, ADELAIDE SA 5001
Telephone: 8204 9555 (Bonds) Refunds available between
8204 9544 (Tenancy Advice) 9 am and 4.30 pm; Mon - Fri

NOTIFICATION OF CHANGE IMPORTANT

This form cannot be used if
OF TENANT the security bond has been
provided by the SAHT.
PLEASE FILL OUT FORM IN CLEAR PRINT USING BLUE PEN
This form cannot be
Address of rental premises (use block letters) processed without the
signature of the
landlord/agent.
Postcode

Previous tenant details as listed on bond lodgement (use block letters)

I AGREE TO RELEASE MY INTEREST IN THE BOND TO THE NEW TENANT(S)
Surname First Names Phone Signature

New tenant details (use block letters)

Surname First Names Phone Signature

Landlord / agent details (use block letters) Contact details

Name
Address Contact phone number
Work
Postcode Home

Change of tenant’s effective from Date / /

SIGNATURE OF
LANDLORD/AGENT Date / /

THIS FORM WILL NOT BE ACCEPTED UNLESS ALL SECTIONS ARE FULLY COMPLETED

TB 06/2006