AMENDED - DA Form 1

PART 9 —-FOR COMPLETION OF THE ASSESSMENT MANAGER - FOR OFFICE

USE ONLY

Date received: [ Reference number(s): |

 

Notification of engagement of alternative assessment manager

Prescribed assessment manager

|

 

 

Name of chosen assessment manager

 

Date chosen assessment manager engaged

 

Contact number of chosen assessment manager

 

Relevant licence number(s) of chosen assessment
manager

 

 

 

escription of the work

QLeave notification and payment
Note: For completion by assessment manager if applicable
D

 

QLeave project number

 

Amount paid ($)

Date paid (dd/mm/yy)

 

Date receipted form sighted by assessment manager

 

Name of officer who sighted the form

 

 

 

 

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DA Form 1 — Development application details
Version 1.3— 28 September 2020