Property and Applicant Details Sample Clauses

Property and Applicant Details. PROPERTY NAME LANDHOLDER DETAILS (Landholder can be the owner, leasee or tenant of the land) FULL NAME(S) POSTAL ADDRESS (ES) Telephone: (H) E-mail: (W) FAX (mob) I/We as landholder(s) (owners/leasees/tenants) desire to have this property assessed for either a WILDLIFE REFUGE or CONSERVATION AGREEMENT (circle your status and your preference). DATE ‌ Name (print) Signature Name (print) Signature Name (print) Signature Name (print) Signature PROPERTY DETAILS LGA Catchment- CMA Property Address Property Location Distance & direction from nearest landmark (e.g. 5km west of Bathurst) Lot or Portion Number: D.P. Number Parish and County: Area (Ha) Freehold or Leasehold DECCW Conservation Partners Program: Property Application/Proposal Form Page 1 of 7 (Last update February 2010)
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