Revised DA Form 1

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

USE ONLY

 

Date received: | | Reference number(s): |

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

 

 

 

Description of the work

 

QLeave project number

 

Amount paid ($) I

Date paid (dd/mmiyy)

 

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