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Property Details

Assessment No

Property Address

Owner Details

Family Name

Given Name

Date of Birth

Name

Previous Addess

Address

Address 2

City/Town

ZIP/Postal Code

Residential Address

Address

Address 2

City/Town

ZIP/Postal Code

Is postal address same as residential address?

Yes

Postal Address

Address

Address 2

City/Town

ZIP/Postal Code

Contact Numbers

Please note: If there has been a change of ownership or change of name due to marriage or other reasons, or an owner is deceased, it will be necessary for additional documentation to be supplied to council for records to beamended e.g. copy of title, copy of marriage certificate,etc.
This form is NOT to be used as notification of change of ownership, and will not be accepted by the City of Karratha for this purpose.

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Planning

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Pet Name/Rego Number

Name of person completing this form:

Applicant Signature

Sign above

Date

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Acknowledgment of Country

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