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DA Form 1 & Plan
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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 Page 12 DA Form 1 — Development application details Version 1.3— 28 September 2020
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