For Appointment of a Specialist Retail Valuer by The

Retail Leases Act 2003 APPLICATION For Appointment of a Specialist Retail Valuer by the Victorian Small Business Commissioner

Before completing this application form, consider talking this matter over with your Solicitor or contacting the Victorian Small Business Commissioner’s office on 13 VSBC (13 8722).

This form may be used to request the appointment of a specialist retail valuer by the Small Business Commissioner.

If a landlord and tenant cannot agree on an amount of rent payable pursuant to a retail lease and cannot agree upon the appointment of a specialist retail valuer to determine the rent, then either party may apply to the Small Business Commissioner for the appointment of a specialist retail valuer.

Information relating to the relevant provisions of the Retail Leases Act 2003 (Sections 33 to 38) can be found under the Retail Leasing, Specialist Retail Valuers section of the Victorian Small Business Commissioner’s website (www.vsbc.vic.gov.au).

If you have any questions relating to the appointment of a specialist retail valuer, please contact the office on 13 VSBC for assistance.

When you submit this application you must include:

* A copy of the most recent lease. (Also include copies of such documents as transfer of lease or assignment of lease if applicable.)

* Evidence to show that the tenant and landlord have attempted to reach their own agreement on rent and a valuer to perform a rental determination prior to the submission of this application. Include the names of any valuers that either party may have suggested be used or have approached.

Applicant Details Name of person making application

Address

Phone (b/h)

Application is being made on behalf of tenant or landlord

Premises Details Street address of premises, including shop number(s) if applicable, and Suburb/City/Town

Shopping centre name (if applicable)

Postcode

Type of use of the premises

Date of commencement of the current lease or lease extension Landlord Details If there is more than one landlord, provide the name and address of the second and subsequent landlords, and of their representatives, using copies of the attachment to this form

If landlord is a company OR If landlord is not a company

Company Name (on lease) Name (on lease)

Company ACN or ABN (if known)

Name of natural person contact for landlord

Street or postal address, including Street or postal address, including Suburb/City/Town and State Suburb/City/Town and State

Postcode Postcode

Phone (b/h) Phone (b/h) email (if landlord has an email address) email (if landlord has an email address)

Name of representative of landlord (eg solicitor or estate agent)

Street or postal address, including Suburb/City/Town and State

Postcode

Phone (b/h) email (if representative has an email address)

Tenant Details If there is more than one tenant, provide the name and address of the second and subsequent tenants, and of their representatives, using copies of the attachment to this form If tenant is a company OR If tenant is not a company

Company Name (on lease) Name (on lease)

Name of natural person contact for tenant

Postcode Postcode

Phone (b/h) Phone (b/h) email (if tenant has an email address) email (if tenant has an email address)

Name of representative of tenant (eg solicitor or estate agent)

Postcode

The following must be addressed before your application is considered:

(Where applicable, please tick the appropriate boxes) 1. What is the current annual rent?

2. What is the date from which the determined rent should begin? (Can be prior to determination taking place)

3. Has there been any attempt by the involved parties to reach an agreement on a rental amount prior to seeking the assistance of the Small Business Commissioner?

Yes: No:

4. Has there been an attempt by the involved parties to reach an agreement on a valuer prior to seeking the assistance of the Small Business Commissioner?

Yes: No:

5. Have you approached the REIV, API or RICS prior to lodging this application?

Yes: No: If so, who? REIV API RICS

6. Does the lease expressly mention the REIV, API or RICS as the body to appoint a valuer?

Yes: No: If so, who? REIV API RICS

7. Are there valuers or businesses that provide valuation services that would be of a conflict of interest with either party?

Yes: No: If the answer is yes please specify: ......

8. Any other comments you regard as relevant: ......

SIGNATURE: ...... Date: ...... /...... /......

To Victorian Small Business Commissioner

Level 2, 121 Exhibition Street, Melbourne VIC 3000 Phone: 13 VSBC (13 8722) Email: [email protected] GPO Box 4509, Melbourne VIC 3001 TTY: 03 9651 7596 Website: www.vsbc.vic.gov.au DX 210074 Melbourne Fax: 03 9651 9943

Privacy Statement: Consistent with Victorian Government policy, the Department endorses fair information handling practices. The Department of State Development, Business and Innovation do not collect or record personal information, except that which you provide freely via specific forms. Any information provided will be treated as confidential and used only for the purpose intended or stated on the form unless in exceptional circumstances where authorised by law.

Attachment To be used if there is more than one landlord/tenant, to provide the name and address of the second and subsequent landlord/tenant, and of their representatives

Information relating to:

Second / Third / Fourth / Fifth (circle applicable landlord or tenant number)

Landlord / Tenant (circle applicable)

If landlord/tenant is a company OR If landlord/tenant is not a company

Company Name Name

Name of natural person contact for landlord/tenant

Postcode Postcode

Phone (b/h) Phone (b/h) email (if landlord/tenant has an email email (if landlord/tenant has an email address) address)

Name of representative (eg solicitor or estate agent)

Postcode