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Property Address
Tenant Name
Date of Request
I/We confirm that:
  • We wish to perform a minor change to the Premises, as detailed on the following page.
  • The requested minor change:

    a) presents no more than a low risk of material damage to the Premises; and

    b) would allow the Premises to be returned easily to substantially the same condition; and

    c) does not pose a risk to health and safety (including during work to install, remove, or undo the minor change) that cannot reasonably practicably be eliminated or minimised; and

    d) does not compromise the structural integrity, weathertightness, or character of any building; and

    e) would not have an unreasonable negative effect on any person’s enjoyment or use of any property outside the Premises; and

    f) does not require any regulatory consent (for example, a building consent); and

    g) does not breach any obligation or restriction relevant to the Premises (for example, an obligation or a restriction imposed by a bylaw, a planning or body corporate rule, or a covenant).

  • If the Landlord consents to the requested minor change, I/We will, on or before the expiry of the tenancy, return the Premises to a condition that is substantially the same as the condition that the Premises were in before the minor change was made, unless the Landlord and the I/we agree a different arrangement in relation to the minor change for the end of the tenancy (for example, that the minor change will remain in place).

  • This request has been made in accordance with section 42A and 42B of the Residential Tenancies Act 1986.

I/We acknowledge and understand that the Landlord has twenty-one (21) days to respond to this request in accordance with section 42A of the Residential Tenancies Act 1986.