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FORM RT04a

Notice by Landlord to Tenant to Remedy
Breach of Term of Agreement
Please complete this form using BLOCK LETTERS
To Mr/Mrs/Ms/Miss
(insert name of tenant)

Address of
Premises:

Postcode:

a. I give you notice that you are in breach of the residential tenancy agreement that relates
to the premises referred to above.
The breach is as follows:
(set out particulars of breach)

_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
(if insufficient space, attach a separate sheet)

In accordance with section 96B of the Residential Tenancies Act you are required to remedy this breach, or take steps to the
landlord’s satisfaction to do so, before the compliance day, being ___ / ___ / ____
(see note 1 page 2 giving of Notices)

b. You are required to take the following action:
(include enough d