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ApplicationDetails

Electronic Application for Adjudication Certificate
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This form is to be used to make an electronic application for an adjudication certificate under the Building and Construction Industry Payments Act 2004 (Qld).
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Fee: The fee for the issuing of an adjudication certificate is a statutory fee based on the claimed amount. The fee must accompany this request. The claimant requests QBCC to provide an adjudication certificate under s30 of the Building and Construction Industry Payments Act 2004 (QLD). Note: A request for an adjudication certificate cannot be validly made until after 5 (five) full business days have elapsed from the date the Adjudication Decision was served on the Respondent or until after the due date for payment decided by the Adjudicator, whichever is the latter.
Please complete all details of this application where applicable
The claimant hereby applies for an adjudication certificate under s30 the Building and Construction Industry Payments Act 2004 (The Act). Section 30 of the Act states that a claimant may apply to the Registrar to provide an Adjudication Certificate if the respondent fails to pay the whole or any part of the adjudicated amount to the claimant under section 29. The Claimant must ensure all details are correct and complete.

Adjudication details

Claimant details

What is the claimant type? *
At least one of the phone or mobile numbers is required *

Contact person

Postal address

Have you moved since lodging adjudication application *
Do you want your QBCC contact details updated? *
Preferred method of contact *

Old address

Agent contact details

What is the agent type? *
At least one of the phone or mobile numbers is required *

Contact person

Agent postal address

Other details

Where would you like your certificate sent? *

Fees

Upon submission of this form you will be asked to pay an application fee of the amount shown below.If payment fails the application will not be deemed to have been lodged. Please keep a receipt of the transaction to confirm payment. For any issues with payment please contact the registry during business hours on 13 93 33.
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Declaration

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