Request to Correct or Clarify Order or
Obvious Error
The Residential Tenancies Act, 2006 [section 76]
Application Number:
(A request must be made within 15 days of the date of the decision or order. There is a
fee of $5.00 to request a correction or clarification.)
(Name of landlord or tenant)
hereby requests that the Office of Residential Tenancies:
•
Clarify the Decision or Order
Set out part or parts for clarification:
and/or
•
Deal with an obvious error or inadvertent omission
Set out the error or omission:
Date:
Signature:
Name (Please Print)
March 2016
Address
Form 11
Office of Residential Tenancies
Office of Residential Tenancies
Credit Card Payment Form
PLEASE PRINT CLEARLY
Application No.:
(if known)
Date
TO:
Office of Residential Tenancies:
304 – 1855 Victoria Avenue
REGINA SK S4P 3T2
105 – 122 – 3rd Avenue North
SASKATOON SK S7K 2H6
OR
Toll Free Callers: 1-888-215-2222
Out of Province Callers: 1-306-787-2699
Toll Free Fax: 1-888-867-7776
Out of Province Fax: 1-306-787-5574
With Regard to:
Premises Address:
Tenant(s):
My credit card number and expiry date are listed below:
Mastercard
Visa
Account Number:
Expiry Date:
CVR Number from the back of the card (3 digits):
Security Deposit Amount Being Paid
$
Application Fee Amount Being Paid
$
Total Amount to be Charged
$
Thank you.
Yours truly,
Print above and sign below.
Authorized Signature
App #
0.00