Approved form AF2002-231

approved by the delegate of the Minister for Planning on 21 November 2002 under the
Unit Title Act 2001, s 180 (Approved Forms)

Unit Title Act 2001 – Form 4
(see s 146)

Australian Capital Territory

Application for a Unit Entitlement Authority

(See attached form entitled Application for a Unit Entitlement Authority)

Unauthorised version prepared by ACT Parliamentary Counsel's Office

Unit Titles Act 2001 - Form 4

Application for a Unit Entitlement	Authority

When should you use this form?

This form should be completed when applying to amend the Schedule of Unit Entitlement of a Units Plan.
Please supply the following with your application:
•	the original plus three (3) paper copies of the Schedule of Unit Entitlement (Form 2);
•	certification of the amended Schedule of Unit Entitlement by a Member of the Institute of Valuers;
•	copy of the unopposed resolution of the owners corporation dated within 3 months of submitting this application;
•	the application fee;
•	if you are an agent: authority to act on behalf of the owners corporation;
•	any additional information necessary to finalise your application.

Privacy Notice: The personal information on this form is being collected to enable processing of your application. Collection of personal information is authorised by Part 15 of the Unit Titles Act 2001.

Part 1:	Lease/Site details

Block Section
Suburb
Units Plan No.
Street address

Part 2:	Applicant details

Surname or Company name
Title / First Name / Initials or Australian Company Number (ACN)
If a company Name of contact person

Postal address

Suburb

State/Territory

Postcode Phone number (business hours)
Fax number

Email

Planning and Land Management

OFFICE USE ONLY
Fees

Date received
/	/
Receipt number

Receiving officer

Australian Capital Territory Government

Unauthorised version prepared by ACT Parliamentary Counsel's Office

UT Approval Form4-11/02

Part 3:	Applicant’s declaration

I/we the undersigned, being the applicant(s) nominated in this application, hereby apply for approval to amend the Schedule of Unit Entitlement described in this application on the land specified in this application.
I/we hereby authorise ACT Government Officers to access the subject property(s) for the purpose of evaluating the proposal.
I/we understand that payment of additional fees may be required.
I/we declare that all the information I/we have given on this form and its attachments is true and complete.

Signature(s) If a company, capacity/authority
Date

Part 4:	Owners corporation details

1st Executive Member’s details (If the same as applicant, write ‘see applicant’) Surname or Company name

Common Seal

Title / First Name / Initials or Australian Company Number (ACN)
If a company Name of contact person

Postal address

State/Territory

Suburb Postcode
Phone number (business hours)

Fax number

Email

Executive Member’s Signature
Signature

2nd Executive Member’s details
Surname or Company name
Title / First Name / Initials or Australian Company Number (ACN)
If a company Name of contact person

Postal address

State/Territory

Suburb Postcode
Phone number (business hours)

Fax number

Email

2nd Executive Member’s Signature
Signature

UT Approval Form4-11/02

Unauthorised version prepared by ACT Parliamentary Counsel's Office