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Changes not yet applied. Later legislation changes this provision in ways not yet written into the text below:

Sch. Form 4D 4E inserted by Assured Tenancies and Agricultural Occupancies (Forms) 2003 reg. 2(3) Sch.
Sch. Form 5 words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(7)
Sch. Form 3 words substituted (temp.) by Coronavirus Act 2020 Sch. 29 para. 11(a)
Sch. Form No. 4 revoked by Assured Tenancies and Agricultural Occupancies (Forms) 2003 reg. 3(1)
Sch. Form 3 amendment to earlier affecting provision 2020 c. 7, Sch. 29 para. 1 by Coronavirus Act 2020 (Residential Tenancies: Extension of Period of Protection from Eviction) 2021 reg. 2
Sch. Form 3 amendment to earlier affecting provision 2020 c. 7, Sch. 29 para. 1 by Coronavirus Act 2020 (Residential Tenancies: Extension of Period of Protection from Eviction) 2021 reg. 2
Sch. Form 3 amendment to earlier affecting provision 2020 c. 7, Sch. 29 paras. 1, 11 by Coronavirus Act 2020 (Residential Tenancies: Extension of Period of Protection from Eviction) 2021 reg. 2
Sch. Form 3 amendment to earlier affecting provision 2020 c. 7, Sch. 29 para. 1 by Coronavirus Act 2020 (Residential Tenancies: Extension of Period of Protection from Eviction) 2021 reg. 2
Sch. Form 3 expiry of earlier affecting provision 2020 c. 7, Sch. 29 by Coronavirus Act 2020 s. 89
Sch. Form 3 words substituted (temp.) by Coronavirus Act 2020 Sch. 29 para. 11(b)(i)
Sch. Form 3 words substituted (temp.) by Coronavirus Act 2020 Sch. 29 para. 11(b)(ii)
Sch. Form 3 words substituted (temp.) by Coronavirus Act 2020 Sch. 29 para. 11(c)
Sch. Form 4A omitted by Assured Tenancies and Agricultural Occupancies (Forms) 2003 reg. 2(b)(i)
Sch. Form 4B 4C inserted by Assured Tenancies and Agricultural Occupancies (Forms) 2003 reg. 2(b)(ii) Sch.
Sch. Form 5 word substituted by Transfer of Tribunal Functions 2013 Sch. 2 para. 15(a)
Sch. Form 5 words inserted by Transfer of Tribunal Functions 2013 Sch. 2 para. 15(b)
Sch. Form 6 word substituted by Transfer of Tribunal Functions 2013 Sch. 2 para. 16(a)
Sch. Form 6 words substituted by Transfer of Tribunal Functions 2013 Sch. 2 para. 16(b)
Sch. Form 6 words substituted by Transfer of Tribunal Functions 2013 Sch. 2 para. 16(c)
Sch. Form 6 words inserted by Transfer of Tribunal Functions 2013 Sch. 2 para. 16(d)
Sch. Form 6 word substituted by Transfer of Tribunal Functions 2013 Sch. 2 para. 16(e)
Sch. Form 6 word substituted by Transfer of Tribunal Functions 2013 Sch. 2 para. 16(f)
Sch. Form 9 words substituted by Transfer of Tribunal Functions 2013 Sch. 2 para. 17
Sch. Form 4B words substituted by Universal Credit (Consequential, Supplementary, Incidental and Miscellaneous Provisions) 2013 reg. 69(a)
Sch. Form 4C words substituted by Universal Credit (Consequential, Supplementary, Incidental and Miscellaneous Provisions) 2013 reg. 69(b)
Sch. Form 1 words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(2)(a)
Sch. Form 1 words inserted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(2)(b)
Sch. Form 1 words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(2)(c)(i)
Sch. Form 1 words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(2)(c)(ii)
Sch. Form 1 words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(2)(c)(iii)
Sch. Form 1 words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(2)(c)(iv)
Sch. Form 2 heading words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(3)
Sch. Form 2 words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(4)(a)(i)
Sch. Form 2 words inserted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(4)(a)(ii)
Sch. Form 2 words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(4)(b)
Sch. Form 4B words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(5)(a)(i)
Sch. Form 4B words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(5)(a)(ii)
Sch. Form 4B words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(5)(a)(iii)(aa)
Sch. Form 4B words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(5)(a)(iii)(bb)
Sch. Form 4B words inserted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(5)(a)(iv)
Sch. Form 4B words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(5)(b)
Sch. Form 4C words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(6)(a)(i)
Sch. Form 4C words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(6)(a)(ii)
Sch. Form 4C words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(6)(a)(iii)(aa)
Sch. Form 4C words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(6)(a)(iii)(bb)
Sch. Form 4C words substituted by Transfer of Tribunal Functions (Mobile Homes Act 2013 and Miscellaneous Amendments) 2014 Sch. 2 para. 3(6)(b)
Sch. Form 3 amendment to earlier affecting provision 2020 c. 7, Sch. 29 para. 1 by Coronavirus Act 2020 (Residential Tenancies: Protection from Eviction) 2021 reg. 2
Sch. Form D words substituted by Assured Tenancies and Agricultural Occupancies (Forms) 2014 reg. 2(a)
Sch. Form E words substituted by Assured Tenancies and Agricultural Occupancies (Forms) 2014 reg. 2(b)
Sch. Form 4D Notes words substituted by Assured Tenancies and Agricultural Occupancies (Forms) 2014 reg. 2(a)
Sch. Form 4E Notes words substituted by Assured Tenancies and Agricultural Occupancies (Forms) 2014 reg. 2(b)
Sch. Form 4A inserted by Assured Tenancies and Agricultural Occupancies (Forms) 2002 reg. 3(3) Sch.
Sch. Form 4 revoked by Assured Tenancies and Agricultural Occupancies (Forms) 2002 reg. 4(1)
Sch. Form 3 amendment to earlier affecting provisions 2020 c. 7, Sch. 29 paras. 1, 11 by Coronavirus Act 2020 (Residential Tenancies: Protection from Eviction) 2020 reg. 3 15(2)
Sch. Form 3 amendment to earlier affecting provision 2020 c. 7, Sch. 29 para. 11(a) by Coronavirus Act 2020 (Assured Tenancies and Assured Shorthold Tenancies, Extension of Notice Periods) 2020 reg. 2(4)(a)
Sch. Form 3 amendment to earlier affecting provision 2020 c. 7, Sch. 29 para. 11(b)(i) by Coronavirus Act 2020 (Assured Tenancies and Assured Shorthold Tenancies, Extension of Notice Periods) 2020 reg. 2(4)(b)(i)
Sch. Form 3 amendment to earlier affecting provision 2020 c. 7, Sch. 29 para. 11(b)(ii) by Coronavirus Act 2020 (Assured Tenancies and Assured Shorthold Tenancies, Extension of Notice Periods) 2020 reg. 2(4)(b)(ii)

To be signed and dated by the landlord or his agent (someone acting for him) or the tenant or his agent. If there are joint landlords or joint tenants each landlord/tenant or the agent must sign unless one signs on behalf of the rest with their agreement.

Please specify whether: landlord□ landlord’s agent□ tenant□ tenant’s agent□

(b)

Name and address of landlord or tenant referring to the rent assessment committee.