Tenant information
Provider business name	Click here to enter housing provider name.
Client name	Click here to enter name.
Client number (SWN)	Click here to enter SWN.
Client name	Click here to enter name.
Client number (SWN)	Click here to enter SWN.
Address	Click here to enter street number.
Click here to enter street name.
Click here to enter suburb.
Click here to enter town/city.
Click here to enter postcode.
Current income-related rent	Enter the IRR the household was being charged.	New income-related rent	Enter the new IRR amount that the refund has been assessed on.
Date income-related rent refund period is from	Enter a date.	Date income-related rent refund period is to	Enter a date.
Comments	Include any additional information you feel is necessary.
Information on rent arrears owing
Date rent arrears is from	Enter a date.	Date rent arrears is to	Enter a date.
Rent arrears total for the refund period	$ Click here to enter amount of rent owed.
Payment reference number	Insert number (nine digit code).
Comments	Include any additional information you feel is necessary.