G PO Box 1722 Darwin NT 0801
Facsimile: 08 8999 6226
Email: [email protected]
Website: www.cjc.nt.gov.au
Application for Adjudication
For adjudication of construction contracts payment disputes under $10,000 pursuant to the Construction Contracts (Security of Payments) Act 2004 and in accordance with Part 4 of the Community Justice Centre Act 2005.
Applicant details: Respondent details:
Company name |
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Company name |
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Street address |
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Street address |
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Postal address |
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Postal address |
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Contact name |
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Contact name |
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Phone |
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Phone |
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Mobile |
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Mobile |
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Fax |
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Fax |
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Enter amount of claim and give brief details of the dispute: |
This application is made in respect of a payment dispute in the amount of $................... Details: ………………………………………………………………………………………………………………………………
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Lodgement requirements: |
A lodgement fee of $500 is payable with this completed application form. Lodge with any relevant documentation at: Community Justice Centre, Level 1 Nichols Place Darwin Magistrates Court.
Please make cheques payable to Community Justice Centre Trust Account. |
Office use only
Date received |
Amount paid |
Receipt no. |
Contract price verified |
Documentation received |
Adjudicator |
File number |
Brief sent |
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Department of Justice
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