Name and Address Alteration Form
Owner/s Name (Please provide full names)
Owner/s Residential Address
If No which assessment numbers does this change apply to:
Do you own a Dog/Cat?
Privacy Notification: The personal information requested on this form is being collected by Council to maintain an accurate name and address register. The personal information will be used solely by Council for that primary purpose or directly related purposes. The applicant understands that the personal information provided is for council records and that they may apply to Council for access and or amendment of the information.