Approved form AF2002-232

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 5
(see s 30)

Australian Capital Territory

Application to amend a Development Statement after Registration

(See attached form entitled Application to amend a Development Statement after Registration)

Unauthorised version prepared by ACT Parliamentary Counsel's Office

Unit Titles Act 2001 - Form 5

Application to amend a Development Statement after Registration

When should you use this form?

This form should be completed when applying to amend a development statement after registration and prior to the completion of the development.
Please supply the following with your application:
•	copy of the unanimous resolution of the owners corporation dated within 3 months of submitting this application;
•	copies of the written agreement of each interested non-voter where applicable;
•	copies of the approved plans for any internal unit or common property boundary changes;
•	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 Form5-11/02

Part 3:	Applicant’s declaration

I/we the undersigned, being the applicant(s) nominated in this application, hereby apply to amend the development statement 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:	Lessee details

1st Lessee 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

Lessee Signature
Signature

2nd Lessee 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 Lessee Signature
Signature

UT Approval Form5-11/02

Unauthorised version prepared by ACT Parliamentary Counsel's Office

Part 5:	Description of Amendment to Development Statement

Please tick appropriate box

-	How the staged development is to be carried out

-	Internal boundaries between units or between units and the common property

-	The schedule of unit entitlement

-	Other

Description

Unauthorised version prepared by ACT Parliamentary Counsel's Office

UT Approval Form5-11/02