Manufactured homes Form 5
Termination notice—by home owner
Manufactured Homes (Residential Parks) Act 2003
This form is effective from 20 August 2014

Warning 
Before signing this form, seek independent professional advice from a solicitor, community legal service or financial adviser.
A home owner (or home owners) can complete this form and give it to the park owner/manager to give notice that they wish to terminate the site agreement.

Instructions
Give this notice to the park owner/manager no later than 28 days before the agreement is to be terminated.
The park owner/manager should keep this form for at least 1 year after the termination date.
Please complete this form in BLOCK letters. Attach extra pages if needed.
Give all references to dates as DD/MM/YYYY.
If you need help completing this form, please contact the Department of Housing and Public Works on 13 QGOV (13 74 68).

Home owner/s
Name/s of home owner/s

Person 1
Preferred title Mr Mrs Ms Miss Other (specify) .................
First name ...................................... Last name .........................................

Person 2
Preferred title Mr Mrs Ms Miss Other (specify) ................
First name ...................................... Last name .........................................

Site and park
Park name ..................................................................................................
..................................................................................................................
Site number (if applicable) .........................................................................
..................................................................................................................
Park address ..............................................................................................
..................................................................................................................
Suburb ......................................... State Postcode

Reason for termination
Please provide a short description of the reason/s for giving this notice
(e.g. relocating home to another park). .......................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................

Termination date I/We intend to terminate the site agreement and give up vacant possession
of the site at midnight on / / Date of this notice / /

Signature/s of home owner/s Signature 1 .................................................................................................
Name (please print) ....................................................................................
Date signed / /

Signature 2 ................................................................................................
Name (please print) ....................................................................................
Date signed / /

Further information
If you would like more information, contact the Department of Housing and Public Works on
13 QGOV (13 74 68) or visit our website at www.hpw.qld.gov.au.

Residential Services Unit
The Residential Services Unit regulates the Manufactured Homes (Residential Parks) Act 2003. This includes investigating complaints and alleged breaches of the Acts.

Department of Housing and Public Works
GPO Box 690, Brisbane, QLD 4001
Phone: 07 3008 5824
Email: residentialservices@hpw.qld.gov.au 
Website: www.hpw.qld.gov.au/housing

The Park and Village Information Link (PAVIL)
Specialist service providing free information and legal assistance for residents and prospective residents of retirement villages and manufactured home parks in Queensland.

Caxton Legal Centre Inc.  
1 Manning Street, South Brisbane, QLD 4101
Phone: 07 3214 6333
Email: caxton@caxton.org.au
Website: www.caxton.org.au 

Seniors Legal and Support Services Centres
These centres provide free legal and support services for seniors concerned about elder abuse, mistreatment or financial exploitation.

Caxton Legal Centre Inc.  
1 Manning Street, South Brisbane, QLD 4101
Phone: 07 3214 6333
Email: caxton@caxton.org.au
Website: www.caxton.org.au/sails_slass 

Queensland Civil and Administrative Tribunal (QCAT)
This independent decision-making body helps resolve disputes and reviews administrative decisions.

GPO Box 1639, Brisbane, QLD 4001
Phone: 1300 753 228
Email: enquiries@qcat.qld.gov.au
Website: www.qcat.qld.gov.au

Queensland Law Society
Find a solicitor

Law Society House
179 Ann Street, Brisbane, QLD 4000 
Phone: 1300 367 757
Email: info@qls.com.au
Website: www.qls.com.au

Department of Justice and Attorney-General
Dispute Resolution Centres provide a free, confidential and impartial mediation service to the community.

Phone: 07 3006 2518
Toll free: 1800 017 288
Website: www.justice.qld.gov.au