Enter a notice given to an SDA resident

Notice details
Review

Notice details

When you've issued a notice to a resident that has an SDA agreement you must notify Consumer Affairs Victoria using this form.

For more information about SDA residency agreements please visit the Specialist disability accommodation page on the Consumer Affairs Victoria website.

All questions must be answered, unless marked 'optional'.

To continue, please...

Provide a valid answer to these questions:

Notice

Notice type

Notice of Temporary Relocation

Notice to Vacate

Notice of Intention to Vacate

Notice of Withdrawal

Notice of Intention to Terminate

I am a

SDA provider

Owner

Mortgagee

Date notice given

YYYY

Effective date

YYYY

Dwelling address

Dwelling address Begin typing and select the correct address from the list. If the address is not listed select 'none of the above' and enter the address manually.

Address line 1

Address line 2 (optional)

Suburb or town

State

Postcode

Country

Address line 1

Address line 2

Suburb or town

State

Postcode

Country

Room number (optional) If there is more than one resident in the dwelling, add the room or part of the property for this agreement.

SDA provider details

Provider registration number (PRN) A PRN has a number then a hyphen at the start. For example, 1-111A-1111 or 1-1111-111.

SDA provider name

SDA provider address Begin typing and select the correct address from the list. If the address is not listed select 'none of the above' and enter the address manually.

Address line 1

Address line 2 (optional)

Suburb or town

State

Postcode

Country

Address line 1

Address line 2

Suburb or town

State

Postcode

Country

Email address

Mobile phone number (optional)

Business phone number (optional)

Owner details

Owner's name

Email address

Mobile phone number (optional)

Business phone number (optional)

Mortgagee details

Mortgagee's name

Email address

Mobile phone number (optional)

Business phone number (optional)

To: Review