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Remove household member

Use this form to let us know if one or more people have moved out of your home.You should tell us within 28 days of the person moving out, so your rent can be reassessed.

If the person who moved out is a legal tenant (they signed the State Tenancy Agreement), they must complete a Residential Tenancies Authority (RTA) - Notice of Intention to Leave form (Form 13).

You will need to provide current income details for all remaining household members. You can either attach the documents when submitting this request, or send them to your nearest Housing Service Centre.

Your personal details

*



(e.g. 12/06/1971)


Email
Phone
Mail

*

(You must provide at least one contact number)



Your address

If you cannot find your suburb by name, please enter your postcode. If there is no match, please contact your nearest Housing Service Centre





Your postal address

PO Box
Street address


Same as above

*




Who has moved out?

*

*

*

*

Current incomes for all remaining household members

You will need to provide current incomes for all remaining household members so we can reasssess your rent. You can attach the documents to this form or provide them to your nearest Housing Service Centre.

Attachments

You can attach the evidence to this form or contact your nearest Housing Service Centre to find out what evidence you will need to provide.

(Maximum file size: 10 MB. Preferred file types: PDF, Jpeg, GIF, TIFF)

  1. Files currently attached:



Personal Information Privacy Notice

The Department of Housing is collecting your personal information so we may provide you with housing assistance. To assist you with your housing needs and services, your personal information may be disclosed to partner agencies, service providers, local governments and non-governmental agencies that now, or will, provide you with housing and/or support services. Unless authorised or required by law, your personal information will not be disclosed to any other third party without your consent. More information about the Department's privacy obligation is available on our website at www.housing.qld.gov.au.

Declaration

I confirm the information submitted is true and correct. I acknowledge that it is an offence under the Housing Act 2003 to knowingly give false or misleading information to the department that may influence decisions about the provision of housing services to me.

Disclaimer

While the department will make every effort to provide assistance, completing this form does not guarantee that the department will be able to provide the assistance you require.

 

Licence
Creative Commons Attribution-NoDerivs 3.0 Australia (CC BY-ND 3.0)

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