Business/Company Name: ( If Changing Details for a Business )
Total Page：16
File Type：pdf, Size：1020Kb
Change of Address Form
Please complete this form (both sides) if you wish to advise Council of a change of mailing address. Complete all those sections with an *
Owner(s) Details
Owner 1 Salutation * Mr, Mrs, Miss Ms,Dr (Other)
Family Name *
First Name *
Business/Company Name: ( if changing details for a Business) ______
Position held within Business ______
Date of Birth (optional)
Contact Numbers*:
Home:______Mobile______
Business______Fax______
Email Address ______
Owner 3 Salutation * Mr, Mrs, Miss Ms,Dr (Other)
Family Name *
First Name *
Business/Company Name: ( if changing details for a Business) ______
Position held within Business ______
Date of Birth (optional)
Contact Numbers*:
Home:______Mobile______
Business______Fax______
Email Address ______Owner 2 * Salutation * Mr, Mrs, Miss Ms,Dr (Other)
Family Name *
First Name *
Business/Company Name: ( if changing details for a Business) ______
Position held within Business ______
Date of Birth (optional)
Contact Numbers*:
Home:______Mobile______
Business______Fax______
Email Address ______
Owner 4 Salutation * Mr, Mrs, Miss Ms,Dr (Other)
Family Name *
First Name *
Business/Company Name: ( if changing details for a Business) ______
Position held within Business ______
Date of Birth (optional)
Contact Numbers*:
Home:______Mobile______
Business______Fax______
Email Address ______ADDRESS INFORMATION * *Previous Postal Address
______
______
*NEW POSTAL ADDRESS -
______
______
*Please change my new contact details for: Tick the relevant box/boxes
All Notices and Council Information
Rates If Rates box is ticked please list all Properties within the City of Swan owned by you.
Property Location( Address) Assessment Number
License Information (Building/Planning /Health Applications
Dog Registration
If dog registration is ticked - please confirm - location where dog is kept if different to mailing address.
*Name of person completing form *Signature Date (Please Print)
______
Office Use Only Officer Name ______Date ______