Complete your response to a QCAT minor debt dispute

This form can be used to respond to a minor debt application that you have been served.

To complete this form you will need to provide:

• your case number
• the name of the applicant and respondent
• the location where the minor debt application was lodged
• any supporting documents.

There is no fee to lodge this application.

1. Can I apply?

   1. Have you received (or been served with) a minor debt application? *

      • Yes
      • No

   2. You are not eligible

      You can only use this form to respond to a minor debt application.

      If you are responding to another application, please use form 36 – Response and/or counter application (PDF, 298KB).

   3. Has it been less than 28 days since you received the application? *

      • Yes
      • No

   4. You may be out of time

      The QCAT rules state your response must be filed within 28 days after you are given a copy of the application. If you did not file a response within this time, the applicant may have applied for a decision by default.

      If the tribunal has made a decision in default of your response, filing this form will not change the decision.

      You can apply to set that decision aside. See more information on decisions by default.

2. Application details

   1. Who is the applicant named in the application? * If there is more than one applicant, please enter all applicant names.
   2. What is the case number? *
   3. What registry was the application filed in? * -please select- Beenleigh Brisbane Cairns Ipswich Southport Townsville Atherton Ayr Barcaldine Beaudesert Biloela Blackwater Bowen Bundaberg Caboolture Caloundra Charleville Charters Towers Childers Chinchilla Clermont Cleveland Cloncurry Cooktown Coolangatta Cunnamulla Dalby Emerald Gatton Gayndah Gladstone Goondiwindi Gympie Hervey Bay Holland Park Hughenden Ingham Innisfail Julia creek Kingaroy Landsborough Longreach Mackay Mareeba Maroochydore Maryborough Mitchell Moranbah Mossman Mount Isa Murgon Nambour Nanango Noosa Normanton Oakey Pine Rivers Pittsworth Pomona Proserpine Quilpie Redcliffe Richlands Richmond Rockhampton Roma Sandgate Sarina St George Stanthorpe Tambo Taroom Thursday island Toogoolawah Toowoomba Tully Warwick Weipa Wynnum Yeppoon
3. Response details

   1. Do you agree to any claims in the application? *

      • Yes
      • No
   2. What paragraphs of the application do you agree to? *
   3. Do you disagree with any claims in the application? *

      • Yes
      • No
   4. What paragraphs of the application do you disagree with? *
   5. Do you agree to owing money to the applicant? *

      • Yes
      • No
   6. How much do you owe to the applicant? *
   7. Do you dispute owing money to the applicant? *

      • Yes
      • No
   8. How much do you dispute that you owe to the applicant? *
   9. Do you have documentation supporting your request? *

      • Yes
      • No
   10. * Please upload any supporting documentation. Attachments must be less than 10MB in total. Approved file types are .doc .docx .pdf .odf .jpg .jpeg .bmp .tif .tiff .png .xls .xlsx.
   11. Is an interpreter required? * The assistance of an interpreter is subject to approval by QCAT.

       • Yes
       • No
   12. Please specify the language or Auslan: *
   13. Do you have any of the following needs? Select all that apply

       1. wheelchair / mobility access
       2. speech impairment
       3. hearing impairment/loss
       4. vision impairment/loss
       5. other
   14. Please provide details: *
4. Your details

   1. Are you responding as an individual or entity? *

      • Individual
      • Entity
   2. 1. Entity name *
      2. ACN/ABN *
   3. Name

      1. Title * Mr Mrs Ms Miss Dr
      2. Given name *
      3. Family name *
   4. Address

      1. Address line 1 *
      2. Address line 2
      3. 1. Town, city or suburb *
         2. State * QLD VIC NSW ACT TAS SA WA NT
         3. Postcode *
   5. Phone * Home, Mobile or work number
   6. Alternative Phone Home, Mobile or work number
   7. Email * Example: jane.smart@example.com
   8. Do you identify as Aboriginal or Torres Strait Islander? *

      • No
      • Yes, Aboriginal
      • Yes, Torres Strait Islander
      • Yes, both Aboriginal and Torres Strait Islander
5. Acknowledgement

   1. Section 216 of the Queensland Civil and Administrative Tribunal Act 2009 makes it an offence for a person to knowingly give the registry documents containing false or misleading information. Maximum penalty—100 penalty units.
   2. Acknowledgement

      * The information in this application is true to the best of my knowledge.
   3. Acknowledgement

      * I have completed all of the questions on this response.
   4. Acknowledgement

      * I have provided the correct number of copies of the application form and attachments (that is, a copy for each party, plus one for the Tribunal).
   5. Acknowledgement

      * I have attached all relevant documents, including but not limited to, any agreements, contracts, invoices, receipts and colour copies of photographs.
   6. Acknowledgement

      * I am ready to proceed.