Customer Request Management Entry

Instructions

PRIVACY NOTIFICATION STATEMENT - Any personal information provided, is required for the purpose of processing your request and will be protected in accordance with the provisions of the Privacy and Data Protection Act 2014 and Councils Information Privacy Policy. You have a right to access your personal information collected by Council. The information will not be disclosed to anyone outside of Council and will be kept secure and destroyed in accordance with the Public Records Act. If you choose not to provide the information that is sought, we may be unable to process your request or to update you on the outcome. Please note: We are unable to communicate or update you on progress in relation to your request if you provide incorrect contact information

Community Infrastructure Levy DCPO 2 per dwelling

Has title been released - If No, please contact Strategic Planning and Design on 9217 2145 and do not proceed with this request (Required)

Yes

Customer Details

Customer

Name

Title

Surname / Company

Given

Contact Details

Residential address

Street address

Street address 2

Street address 3

Postcode

Postal address if different from residential

Street address

Street address 2

Street address 3

Postcode

Work

Home Phone

Mobile

Fax

Contact By

Fax

Letter

Not required

Telephone

Full Name / Company Name (Required)

Contact number (Required)

Email or Postal Address (Required)

Please note: This payment is for 1 dwelling

Property Address *

Enter House Number, Street Name and Suburb. Click on search and select the property

Building

Unit Number

Level Number

House Number

Street Name (without type)

Suburb

Title Type

Title 1

Title 2

Title 3

Title 4

Title 5

Title 6

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