Landlord and Tenant.

to make written representations to a tenancy tribunal on the hearing of an application that the premises known as

be exempted from the provisions of the abovementioned Ordinance.

I am interested in the application because

(here state reason, e.g. “I am a sub-tenant of part of the said premises").

[CAP. 255

DATEd the

day of

(Signature or chop)

SCHEDULE

PART III.

FEES.

Where the rent does not exceed $50.00 per month:

Cost of application form $1.00

Every other form $.50

Where the rent exceeds $50.00 per month:

Cost of application form $1.00

Every other form $.50

Filing of application $5.00

In all Cases:

Notice of appeal $10.00

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