DA Form 1

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 1.6— 2 August 2024