[Date]

[Team leader’s name]
Team Leader, [name of local office]
DCJ Housing

Dear …

Re: Application for immediate rehousing for [name]

I am writing on behalf of [name of client]. [name of client] signed a tenancy agreement with DCJ Housing at [address of premises] on [date].

On [date], [name of client] and [number, age and sex of dependant children] were forced to leave the premises because of the violence of [her/his] de-facto [name of de-facto] towards [name of client]. Since that time [name of client] has been housed in a refuge. [name of de-facto] continues to occupy the premises.

[Name of client] has obtained an apprehended violence order. A copy of this order is attached. [Name of client] urgently needs rehousing. [She/he] does not wish to return to the premises. [She/he] would like to be relocated to the [location] suburbs to be close to [her/his] relatives. As [she/he] has [number of children] [she/he] requests [number of bedrooms] bedrooms.

I attach the following documents in support of [her/his] application:

-	a copy of the apprehended violence order

-	a statutory declaration by [name of client], dated [date]

-	a supporting document from [name of refuge], dated [date]

-	a letter from Dr [name of Dr] of [address], dated [date]

-	a DCJ Housing Application for housing assistance, dated [date]

-	a DCJ Housing Transfer and mutual exchange supplement, dated [date]

-	a DCJ Housing Medical assessment, dated [date].

I would appreciate your urgent attention to this matter. Please contact me by phone [phone number], fax [fax number] or email [email address] if you would like any further details.

Yours sincerely

[Tenants Worker]