DA Form 1 SKM_C30823020213560

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

 

 

 

 

QLeave notification and payment

Note: For completion by assessment manager if applicable

Description of the work

 

 

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