Property enquiry & certificates application - V1 - July 2020 Page 1 of 2

Property enquiry & certificates application

About this Form You can use this form to make an enquiry, or request a Certificate for a property within the Council boundaries.How to complete this form 1 Ensure that all fields have been filled out correctly. 2 Please note that all fields on this form marked * are mandatory and must be completed before submitting the

application. 3 Select the certificates and/or information you are applying for. 4 Select your preferred method for delivery of the certificates and/or information. 5 You can only submit online if you have an account set up with us.

Property DetailsLot Number* Section Number*

Address*

Suburb/Town*

Deposited/Strata Plan Number*

Postcode*

Office Use OnlyApplication Number Total Fees Paid Receipt Number Date

Applicant DetailsApplicant(s) Surname/Company* Given Names*

Postal Address*

Postcode*State*Suburb/Town*

Telephone Number* Mobile Number Email Address

Applicant(s) Reference Number

Owners DetailsApplicant(s) Surname/Company* Given Names*

Postal Address*

Postcode*State*Suburb/Town*

Environmental Planning and Assessment Act 1979, Local Government Act 1993, Biosecurity Act 2015

Property enquiry & certificates application - V1 - July 2020 Page 2 of 2

Certificate/Information Collection MethodHow would you like to receive your certificates and/or information?

Email Address

Mail Collect Email

Lodgement DetailsLodge completed application along with payment to be:

• forwarded by post to address below, or • lodged at our Customer Service Counter - Monday to Friday (excluding Public Holidays)

Certificate/Information SelectionApplication is made for:

Planning Certificate - Section 10.7 (2)

Cost:

Planning Certificate - Section 10.7 (2) & (5)

Rates Certificate - Section 603

Certificate as to Orders and Notices - EP & A Act and LG Act

$ 53.00

$133.00

$ 85.00

$ 90.00

Please find enclosed our payment for: $ Our Debtor Account Number:

$ 80.00Urgency fee (additional)

$ 200.00Outstanding Weeds - Biosecurity Act 2015 Clause 28(2) Schedule 7

Applicant's Name* Applicant's Signature* Date*

Forster | 4 Breese Parade | PO Box 450 Forster 2428 | 6591 7222

Gloucester | 89 King Street | PO Box 11 Gloucester 2422 | 6538 5250 Taree | 2 Pulteney Street | PO Box 482 Taree 2430 | 6592 5399

www.midcoast.nsw.gov.au

Privacy: This information is required to process your request and will not be used for any other purpose without seeking your consent, or as required by law. Your application will be retained in Council's Records Management System and disposed of in accordance with current legislation. Your personal information can be accessed and corrected at any time by contacting Council.

Applicant's Consent Council will not process an application that is incomplete or non-complying with lodgement requirements. • I understand if the information is incomplete, the application may be delayed or rejected or more

information may be requested. I acknowledge that if the information provided is misleading, any approval granted may be void.

• I accept delays in processing will arise out of any inadequacies in the material submitted in support of the application.