Please use the form below to request an application for Form 1."*" indicates required fields1Agency Contact Details and Instruction2Vendor Contact Details3Disclaimer and signature Completion of Form I would like Form 1 Solutions to contact the Vendor or their representative to complete this form I will contact the Vendor to arrange completion of this formAgency DetailsAgency*Agent's name* First Last Phone*Email* Vendor Contact DetailsVendor name*PhoneEmail Additional Vendor Contact I'd also like to receive the Form 1 and search information.NameEmail Sale PropertySale Property Address* Street Address Address Line 2 City State Postcode Request Type* Residential Commercial RuralVendor Type* Individual Company Power of Attorney or ExecutorPurchased in*ACN/ABN*Registered address*Mode of Sale* Auction Private Treaty UnknownAuction date* DD slash MM slash YYYY Any other information Form 1Who is to arrange for the Vendor to sign the Form 1?AgentForm 1 SolutionsWho is to serve the Form 1 on the Purchaser?AgentForm 1 SolutionsPurchaser DetailsUnknown I acknowledge that I need to provide contract details once I have received themName* First Last Phone*Email* Disclaimer and signatureTerms and ConditionsAuthorisationI request, direct and authorise J.S.A. Management Pty Ltd (ACN 082 828 699) trading as JSA Form 1 Solutions to undertake all property searches and prepare the Form 1 (the statutory disclosure statement) for the sale contract as required under the Land & Business (Sale and Conveyancing) Act 1994. J.S.A. Management Pty Ltd trading as JSA Form 1 Solutions is requested to prepare and deliver a Form 1 to the agent who is then to deliver and serve with the contract for the sale of my property. I acknowledge that I will examine the Form 1 to confirm its accuracy prior to signing it. I confirm that I am the registered owner (or attorney for the owner) and that I/we are personally liable for the costs of the searches and fees for preparation of the Form 1. I acknowledge and agree to complete to the best of my knowledge the Form 1 Questionnaire and provide it to J.S.A. Management Pty Ltd trading as JSA Form 1 Solutions to enable completion of the Form 1.Terms and Credit (if applicable)Payment of the account is due now via the PayPal portal or otherwise agreed terms between the parties. In the event that credit is extended to me by J.S.A. Management Pty Ltd trading as JSA Form 1 Solutions I understand that payment is due upon settlement of the subject property. I hereby authorise J.S.A. Management Pty Ltd trading as JSA Form 1 Solutions to recover costs from my appointed Conveyancer at the point of settlement if credit is extended to me or persons I am acting on behalf of.In the event that I request J.S.A. Management Pty Ltd trading as JSA Form 1 Solutions to grant credit to me and pay my search costs I acknowledge that J.S.A. Management Pty Ltd trading as JSA Form 1 Solutions is at liberty to charge interest on those costs and its charges at a rate of 12%p.a. and the standard fee for the preparation costs will apply. In this agreement the singular includes the plural.Important notice to the Vendor, or the person signing this Questionnaire for the VendorSections 7 and 9 of the Land and Business (Sale and Conveyancing) Act 1994 require the agent to provide certain information to the purchaser of the land by way of service of the Form 1. This document together with statutory searches will be used to prepare the Form 1 and then provide that information to the purchaser.Acknowledgement by VendorI/we, the Vendor DO HEREBY STATE that to the best of my/our knowledge and after inquiry by me/us the above information supplied is true and correct and is a full disclosure of all required information and I/we will advise the Agent immediately upon becoming aware of any changes to the information herein supplied and any further information arising in relation to the property. I/we am/are aware that incorrect or incomplete information will place the proposed sale of the property at risk and I/we may be liable for incorrect or incomplete information in relation to damages claims which I/we might incur to the Purchaser and or to third parties relying on the information given by me/us.Agree to Terms and Conditions*Tick the box below to agree to the terms and conditions outlined above I agree to the terms and conditions outlined aboveEmailThis field is for validation purposes and should be left unchanged.