Claim for Compensation from the Victorian Property Fund

Claim for compensation from the Victorian Property Fund

Estate Agents Act 1980, Section 81, Conveyancers Act 2006, Section 145

1. Details of claimant(s)

If you need more space, attach a separate page with all claimants’ names and addresses.

Full name of claimant 1
Daytime telephone number
Mobiles OK. If a landline, include area code.
Email address
Full contact address
Full name of claimant 2
Daytime telephone number
Mobiles OK. If a landline, include area code.
Email address
Full contact address

1. Details of estate agent(s) or conveyancer(s) you are making this claim against

If you need more space, attach a separate page with all licensee’s names and addresses.

Full name of licensee 1
Daytime telephone number
Mobiles OK. If a landline, include area code.
Full contact address
Full name of licensee 2
Daytime telephone number
Mobiles OK. If a landline, include area code.
Full contact address

1. Details of your claim

How much money are you claiming from the Fund?
How much money was actually lost?
How much money have you recovered?
Details of any other repayment recovered (non-monetary).
Describe the events that lead you to make this claim
If you need more space, attach a separate page with all licensee’s names and addresses.

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What action have you taken to recover your loss? Provide details of who you contacted and on what dates, what advice they gave you and when
If you need more space, attach a separate page.

1. Supporting documentation

Do you have any documentation to support your claim, e.g. receipts, authorities, rental agreements/leases, accounts, contracts, invoices, records, bank documents and correspondence?

Mark with an X.

For a list of documents you need to submit with your claim, refer to the compensation claims section of the Consumer Affairs Victoria website at consumer.vic.gov.au/housing-and-accommodation/buying-and-selling-property/compensation-claims.

Yes / If yes, attach copies of all documents to this form.
No

1. Certification and signature(s) of claimant(s) (attach a separate page with all claimants’ names, signatures and dates if you need more space)

I certify that:

• the particulars (information) contained in this claim are true and correct and I understand that it is an offence to make and or use a false document
• I understand that if I lodge this form by email, Consumer Affairs Victoria will accept this communication as containing my signature for the purposes of the Electronic Transactions (Victoria) Act 2000.
• I acknowledge that the information contained in this claim will be provided to the person/s against whom the claim is made and may be provided to other agencies or bodies for the purpose of assisting Consumer Affairs Victoria to obtain any other information necessary in dealing with this claim.

Signature of claimant 1
Type name if lodging by email
Full name
Date
dd/mm/yyyy
Signature of claimant 2
Type name if lodging by email
Full name
Date
dd/mm/yyyy

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1. How to lodge this claim

Email:

Post: Consumer Affairs Victoria, GPO Box 123, Melbourne VIC 3001

Telephone enquiries: 1300 55 81 81 (9:00 am to 5:00 pm, Monday to Friday except public holidays)

Privacy

Consumer Affairs Victoria collects and handles your personal information consistent with the requirements of the Privacy & Data Protection Act 2014. Where you do not provide the information required by this form, we may refuse or be unable to process this transaction. We may need to disclose your personal information to other State and Commonwealth Agencies. For more information, view the Privacy statement page on the Consumer Affairs Victoria website (consumer.vic.gov.au/privacy).

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