Application for a new property

Before you begin:

Applicants are encouraged to speak to us prior to lodging an application to ensure all details have been successfully completed.
Assessment of applications may result in additional documentation or information being required. You will be advised if this is the case.

Housing support provider name *(Required)

Contact Full-name *(Required)

Contact position *(Required)

Contact phone *

Contact Email *

Is your organisation a registered NDIS provider?

YesNo

Is your organisation registered with the Australian Charities and Not-for-Profits Commission?

YesNo

Date of application

Head Lease reference

Residential accommodation – leased to eligible persons

Number requested

Proposed use *

Target client group *

Client name(s) - For NDIS Providers

Supports to be provided

Funding source and amount

Note: The above information can be found on the cover page of the Grant Deed or Head Lease.

Name(s) of the other party or parties involved. *

Other relevant information

Additional information should be provided as an attachment to this application.

Please upload any any document requirements

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File upload No.2

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I have read and accept Homes Tasmania requirements as described in the accompanying Fact Sheet

Organisation

Date

Printed Name

Position

Signature

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Captcha *

If you have issues submitting this form, please contact the Homes Tasmania team at commissioning@homes.tas.gov.au

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