Bond Claim Form Example
Example document for Bond Claim Form. Use this as a reference when creating your own.
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Document: Bond Claim Form
Example Document
Last updated 7/30/2026
Bond Claim Form
1. Property Details
Bond Number: 45123989 Rental Property Address: 14 Wallaby Circuit Suburb: Bondi State: NSW Postcode: 2026 Tenancy Start Date: 01/02/2023 Tenancy End Date: 01/02/2024
2. Landlord/Agent Details
Name: Smith Property Management Pty Ltd Phone Number: 02 9123 4567 Email Address: rentals@smithproperty.com.au Address for Notices: 2/100 George St, Sydney NSW 2000 Account Name for Refund: Smith Property Management Trust BSB: 062-123 Account Number: 12345678
3. Tenant Details
Tenant 1 Name: James Jones Signature: J. Jones
4. Claim Details
Total Bond Amount Held: $2200.00
Refund to Tenant
Amount to be paid to Tenant(s): $1950.00
Claim by Landlord/Agent
Reason for Claim: CLEANING / DAMAGE
Please itemise your claim below:
| Description | Amount ($) | Receipt/Quote Attached? |
|---|---|---|
| Oven Deep Clean | $150.00 | Yes |
| Broken Blind Replacement | $100.00 | Yes |
| Total Claimed | $250.00 |
5. Declaration
Tenant Declaration: I/We agree that the landlord/agent may claim the amount of $250.00 from the bond. I/We agree that the remaining amount of $1950.00 should be paid to the bank account listed above.
Tenant Signature: James Jones Date: 03/02/2024
Landlord/Agent Declaration: I/We declare that the information provided in this claim is true and correct. I/We understand that it is an offence to make a false claim.
Landlord/Agent Signature: B. Smith Date: 04/02/2024
Notes
This example shows a mutual agreement where the tenant acknowledges the specific deductions for an oven clean and a broken blind. The receipt numbers are referenced in the attachments. The signatures are dated after the tenancy end date to confirm the final inspection occurred.
About this Example
Part of the Bond Claim Form document collection
Document Type
Bond Claim Form
A formal request to a state authority or financial institution to release a security bond held for a residential or commercial tenancy.