FORM5 - Residential Tenancies Act 1995 (section 80)

Form 5

Residential Tenancies Act 1995 (section 80)
Landlord’s notice of breach to tenant - termination of agreement
Part 1
Note- There are a number of ways in which a tenancy may be terminated under the Residential Tenancies Act 1995, some of which include applyingdirectly to the South Australian Civil and Administrative Tribunal.
Address of rented premises
Name of tenant/s
Street 1
Street 2
Suburb
State
Postcode
Type of breach

Unpaid rent onlyOther breach of agreement
There are 2 types of breaches – 'unpaid rent only' and 'other breach of agreement'. The type of breach will determine the period of time you must give the tenant to give up possession of the premises (see Part 3). You must choose 'other breach of agreement' if serving this notice for both unpaid rent and any other breach of agreement.
The breach is

0/400
You must remedy this breach by

0/400
Part 2
You must remedy the breach on or before

DayMonthYear
Part 3
If the breach is not remedied on or before the date outlined in Part 2 above, then the tenancy is terminated by force of this notice and you must give up possession of the premises on or before

For a breach of unpaid rent onlyFor any other breach of agreement (which may also include unpaid rent)
Date

DayMonthYear
Date

DayMonthYear
Part 4
This notice was served on the tenant on

DayMonthYear
This notice was served by

personally handing it to the tenantmailing it to the tenantplacing it in the tenant's letterboxemailing it to the tenantOther (please specify)
Insert email address
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agentAddressStreetagentAddressSuburbagentAddressStateagentAddressPostcodeagentNameagentMobileNumber
Part 5
Full name of landlord/agent
Mobile Phone Number
Address for service of landlord/agent
Street 1
Street 2
Suburb
State
Postcode
uniqueSubmissionReference
Should be Empty:

Form 5

Landlord’s notice of breach to tenant - termination of agreement

Part 1

Address of rented premises

Part 2

Part 3

Part 4

Part 5

Address for service of landlord/agent