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DA Form
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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-rhanager
Prescribed assessment manager dis
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 ’ ■
/Vote. 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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