Housing Register Advice Form – Community Housing
           Housing Service Provider and Department of Housing 
 Offers advice       	Exit advice     	
Service provider details	
Provider name:	Contact name	
Telephone number:	Fax number:	
Email address:	
Vacant property details	
House/unit number:	Street address:	
Suburb:	Postcode	
Unique property identifier (UPI):	Program	
Describe communal facilities (if any)	
Outcome of referral - Community housing programs	
Application number:	Applicant name:	
 Accepted  	Not offered /Offer withdrawn  	 Housing not required 	Refused  complete Applicant response *	
Offered on:	*Applicant response:	
Comments:

Application number:	Applicant name:	
 Accepted  	 Not offered /Offer withdrawn  	Housing not required 	Refused  complete Applicant response*	
Offered on:	*Applicant response:	
Comments	
Application number:	Applicant name:	
 Accepted  	 Not offered /Offer withdrawn  	Housing not required 	Refused  complete Applicant response*	
Offered on:	*Applicant response:	
Comments:

	
Inactive period - transitional housing only	
Application number:	Applicant name:	
Inactive period:  Yes   No 	Inactive period end date	
Exits - transitional housing only	
Application number:	Tenant name	
Exited on:	Exited to:	
Forwarding address, if known (note: tenant should be advised to update address with Housing Service Centre):	
Comments:

	
Authorised by	
Name:	Position:	
Signature	Date:	
Oct 2023