Form Rents 1 Apply for a determination of a market rent
Section 1 – Type of appeal
Q1. Choose one of the options: Assured tenancy including assured shorthold tenancy, any additional pages. rental value determination (landlord’s notice of increase) Guidance on the Section 13(4) of the Housing Act 1988 application process is online at: www.gov.uk/guidance/apply-for-a-market-rent-determination Agricultural Occupancy – rental value determination (landlord’s notice of increase) Section 13(4) of the Housing Act 1988 Assured Shorthold Tenancy – rental value determination Section 22(1) of the Housing Act 1988
Section 2 – Tenant’s information
Q2.1. Details of tenant to include details of more than one applicant.
Section 2 – Tenant’s information
Q2.1a. First name
Section 2 – Tenant’s information
Q2.1b. Last name
Section 2 – Tenant’s information
Q2.1c. Company name (optional)
Section 2 – Tenant’s information
Q2.2. Applicant type (capacity)
Options: Tenant; Joint tenants
Section 2 – Tenant’s information
Q2.3. Address
Section 2 – Tenant’s information
Q2.3a. First line of address
Section 2 – Tenant’s information
Q2.3b. Second line of address
Section 2 – Tenant’s information
Q2.3c. Town or city
Section 2 – Tenant’s information
Q2.3d. County (optional)
Section 2 – Tenant’s information
Q2.3e. Postcode
Section 2 – Tenant’s information
Q2.4. Reference number for correspondence (optional)
Section 2 – Tenant’s information
Q2.5. Contact details
Section 2 – Tenant’s information
Q2.5a. Phone number
Section 2 – Tenant’s information
Q2.5b. Mobile number
Section 2 – Tenant’s information
Q2.5c. Email address
Section 2 – Tenant’s information
Q2.6. Details of tenant’s representative (if any) Note 2.6: A representative is someone you want to represent you in dealing with the tribunal.
Section 2 – Tenant’s information
Q2.6a. First name
Section 2 – Tenant’s information
Q2.6b. Last name
Section 2 – Tenant’s information
Q2.6c. Company name
Section 2 – Tenant’s information
Q2.7. Address
Section 2 – Tenant’s information
Q2.7a. First line of address
Section 2 – Tenant’s information
Q2.7b. Second line of address
Section 2 – Tenant’s information
Q2.7c. Town or city
Section 2 – Tenant’s information
Q2.7d. County (optional)
Section 2 – Tenant’s information
Q2.7e. Postcode
Section 2 – Tenant’s information
Q2.8. DX number for correspondence (optional)
Section 2 – Tenant’s information
Q2.9. Reference number for correspondence (optional)
Section 2 – Tenant’s information
Q2.10. Contact details
Section 2 – Tenant’s information
Q2.10a. Phone number
Section 2 – Tenant’s information
Q2.10b. Mobile number
Section 2 – Tenant’s information
Q2.10c. Email address
Section 3 – Landlord’s information
Q3.1. Name of landlord
Section 3 – Landlord’s information
Q3.1a. First name
Section 3 – Landlord’s information
Q3.1b. Last name
Section 3 – Landlord’s information
Q3.2. Address
Section 3 – Landlord’s information
Q3.2a. First line of address
Section 3 – Landlord’s information
Q3.2b. Second line of address
Section 3 – Landlord’s information
Q3.2c. Town or city
Section 3 – Landlord’s information
Q3.2d. County (optional)
Section 3 – Landlord’s information
Q3.2e. Postcode
Section 3 – Landlord’s information
Q3.3. Reference number for correspondence (optional)
Section 3 – Landlord’s information
Q3.4. Contact details
Section 3 – Landlord’s information
Q3.4a. Phone number
Section 3 – Landlord’s information
Q3.4b. Mobile number
Section 3 – Landlord’s information
Q3.4c. Email address
Section 3 – Landlord’s information
Q3.5. Details of landlord’s representative or letting agent (if any)
Section 3 – Landlord’s information
Q3.5a. First name
Section 3 – Landlord’s information
Q3.5b. Last name
Section 3 – Landlord’s information
Q3.5c. Company name
Section 3 – Landlord’s information
Q3.6. Address
Section 3 – Landlord’s information
Q3.6a. First line of address
Section 3 – Landlord’s information
Q3.6b. Second line of address
Section 3 – Landlord’s information
Q3.6c. Town or city
Section 3 – Landlord’s information
Q3.6d. County (optional)
Section 3 – Landlord’s information
Q3.6e. Postcode
Section 3 – Landlord’s information
Q3.7. Reference number for correspondence (optional)
Section 3 – Landlord’s information
Q3.8. Contact details
Section 3 – Landlord’s information
Q3.8a. Phone number
Section 3 – Landlord’s information
Q3.8b. Mobile number
Section 3 – Landlord’s information
Q3.8c. Email address
Section 4 – Notices (section 13(4) applications only)
Q4.1. Have you attached a complete copy of the landlord’s Notice of Increase?
Options: Yes; No
Section 4 – Notices (section 13(4) applications only)
Q4.2. Do you agree that the notice served is valid?
Options: Yes; No
Section 4 – Notices (section 13(4) applications only)
Q4.2a. Reasons why you do not accept the notice served is valid
Section 4 – Notices (section 13(4) applications only)
Q4.2b. Evidence in support which is attached - list below
Section 4 – Notices (section 13(4) applications only)
Q4.3. Has the tribunal previously determined the rent for your tenancy?
Options: Yes. The tribunal’s case reference number for the previous determination was; No
Section 5 – Details of your tenancy
Q5.1. What is your current rent?
Section 5 – Details of your tenancy
Q5.1a. Amount
Section 5 – Details of your tenancy
Q5.1b. Frequency (per week, per month)
Section 5 – Details of your tenancy
Q5.2. Does the rent include Council Tax?
Options: No; Yes, give details
Section 5 – Details of your tenancy
Q5.2a. Amount
Section 5 – Details of your tenancy
Q5.2b. Frequency (per week, per month)
Section 5 – Details of your tenancy
Q5.3. Does the rent include any charges for utilities?
Options: No; Yes, give details
Section 5 – Details of your tenancy
Q5.3a. Amount
Section 5 – Details of your tenancy
Q5.3b. Frequency (per week, per month)
Section 5 – Details of your tenancy
Q5.4. When did the present tenancy begin?
Section 5 – Details of your tenancy
Q5.5. Do you have a copy of your tenancy agreement?
Options: Yes. Attach a complete copy to this form, including all terms and conditions.; No. In the box below explain why you do not have a copy of your tenancy agreement.
Section 5 – Details of your tenancy
Q5.6. When does the tenancy end?
Section 5 – Details of your tenancy
Q5.7. Does the present tenancy replace an original tenancy?
Options: No; Yes. Give details below.
Section 5 – Details of your tenancy
Q5.8. When did the original tenancy begin?
Section 6 – Details of premises
Q6.1. What type of accommodation do you rent?
Options: Room(s). Go to question 6.2.; Flat. Go to question 6.2.; Terraced house. Go to question 6.3.; Semi-detached house. Go to question 6.3.; Fully detached house. Go to question 6.3.; Other
Section 6 – Details of premises
Q6.2. If it is a flat or room(s) what floor(s) is it on?
Options: Basement; Ground; First floor; Second floor; Other
Section 6 – Details of premises
Q6.3. Give the number and type of rooms, for example, one living room, two bedrooms, one bathroom
Section 6 – Details of premises
Q6.4. Does the tenancy include any other facilities for example a garden, garage or separate buildings or land?
Options: No; Yes. Give details below.
Section 6 – Details of premises
Q6.5. Do you share the accommodation with your landlord or other tenants?
Options: No; Yes. Give details below.
Section 6 – Details of premises
Q6.6. Attach a photograph showing the exterior of the property Note 6.6 and 6.7: Attach a photograph of the exterior of the property and one photograph of each room, ensuring no personal information is visible
Section 6 – Details of premises
Q6.7. Give approximate size/dimensions of each room
Section 6 – Details of premises
Q6.7a. Room dimensions Photo attached
Section 6 – Details of premises
Q6.7b. Room 1
Section 6 – Details of premises
Q6.7c. Room 2
Section 6 – Details of premises
Q6.7d. Room 3
Section 6 – Details of premises
Q6.7e. Room 4
Section 6 – Details of premises
Q6.7f. Room 5
Section 6 – Details of premises
Q6.7g. Room 6
Section 6 – Details of premises
Q6.7h. Room 7
Section 6 – Details of premises
Q6.7i. Room 8
Section 6 – Details of premises
Q6.7j. Room 9
Section 7 – Furniture
Q7.1. Is any furniture provided to you under the tenancy?
Options: No; Yes. Give details below.
Section 8 – Services
Q8.1. Are any services provided under the tenancy for example cleaning or gardening?
Options: No; Yes. Give details below.
Section 8 – Services
Q8.2. Are you charged separately for services, maintenance, repairs, management costs or any other charges?
Options: No; Yes. Give details below.
Section 8 – Services
Q8.2a. Charge type
Section 8 – Services
Q8.2b. Amount
Section 8 – Services
Q8.2c. Frequency (per week, per month)
Section 8 – Services
Q8.3. Do the charges you pay for the services in question 8.2 vary?
Options: No; Yes. Give details below.
Section 9 – Improvements
Q9.1. Have you or any former tenant(s) carried out improvement work or replaced any fixtures, fittings or furniture for which you or they were not responsible under the terms of the tenancy?
Options: No; Yes. Give details below.
Section 10 – Repairs
Q10.1. What repairs are the responsibility of the landlord?
Section 10 – Repairs
Q10.2. What repairs are the responsibility of the tenant?
Section 11 – What do you say is the market rent?
Q11.1. What do you say is the market rent payable?
Section 11 – What do you say is the market rent?
Q11.2. Do you have any evidence in support of your proposed market rent?
Options: Yes, I have set out my supporting evidence in the box below.; Yes. I have attached supporting evidence.; No
Section 11 – What do you say is the market rent?
Q11.3. Is there any other information you would like the tribunal to take into account in determining the rent?
Options: No; Yes. Give details below.
Section 12 – Inspection and hearing
Q12.1. Do you think an inspection is required for a reason that cannot be illustrated by the photographs?
Options: No; Yes. Give details below.
Section 12 – Inspection and hearing
Q12.2. Is there any reason why you think a hearing is required?
Options: No; Yes. Give details below.
Section 13 – Hardship
Q13.1. Are you suggesting that a rent increase will cause you hardship?
Options: No; Yes. Give details and attach any evidence you wish to rely upon.
Section 14 – Statement of truth
Q14. Statement of truth I believe that the facts stated in this form and any continuation pages are true.
Section 14 – Statement of truth
Q15a. Signature
Section 14 – Statement of truth
Q15b. Date Day Month Year
Section 14 – Statement of truth
Q15c. Full name