When should you use this form?		This form should be used if you want to consolidate leases as part of your Development Application.  This form must be completed and lodged with the relevant Development Application form.	

Property Details Please Print

Give details of the properties you wish to consolidate into one lease, apart from the one you have detailed in your main development application

Property 1

Block	
		Section		
					
Suburb	
		District		
					
Street Address	

__________________________________________________________________________________________
Property 2

Block	
		Section		
					
Suburb	
		District		
					
Street Address	

__________________________________________________________________________________________
Property 3

Block	
		Section		
					
Suburb	
		District		
					
Street Address	

__________________________________________________________________________________________
Property 4

Block	
		Section		
					
Suburb	
		District		
					
Street Address	

__________________________________________________________________________________________
Property 5

Block	
		Section		
					
Suburb	
		District		
					
Street Address	

__________________________________________________________________________________________
Property 6

Block	
		Section		
					
Suburb	
		District		
					
Street Address	

__________________________________________________________________________________________

Privacy Notice
The personal information on this form is provided to the Environment and Planning Directorate (EPD) to enable the processing of your application. The collection of personal information is authorised by the Planning and Development Act 2007.  If all or some of the personal information is not collected EPD cannot process your application. The Planning and Development Act 2007 requires the details of applications, decisions and orders to be kept on a register and made available for public inspection. Information and documentation relevant to a development application may be made available via the Internet. The personal information you provide may be disclosed to Australian Bureau of Statistics, ACT Revenue Office, the Registrar General’s Office, ACTEW Corporation, ActewAGL, Territory and Municipal Services Directorate and other Government agencies with a direct interest in the development assessment process.  The information may also be disclosed where authorised by law or court order, or where the Directorate reasonably believes that the use or disclosure of the information is reasonably necessary for enforcement-related activities conducted by, or on behalf of, an enforcement body. EPD’s Information Privacy Policy contains information about how you may access or seek to correct your personal information held by EPD, and how you may complain about an alleged breach of the Territory Privacy Principles. The EPD Information Privacy Policy can be found at www.environment@act.gov.au 

Does the Commonwealth Environment Protection and Biodiversity Conservation Act 1999 (EPBC) affect your proposal?
The EPBC came into operation on 16 July 2000. It establishes an environmental assessment and approval system that is separate and distinct from the ACT system. It does not affect the validity of ACT development assessment and approval processes, but may affect the assessment track. The ACT cannot provide preliminary advice on whether a proposal falls within the definition of a controlled action, or requires referral to the Commonwealth. You should consult with the Commonwealth to determine if your proposal is a controlled action before seeking any approvals under the Planning and Development Act 2007. For information about the EPBC, including the referral process and when a referral should be made, contact the Commonwealth Department of the Environment www.environment.gov.au 

Contact Details:
Environment and Planning Directorate
Customer Service Centres
GPO Box 158, Canberra City 2601
8 Darling Street Mitchell, ACT 2911
16 Challis Street Dickson ACT 2602
Business Hours: 8.30am to 4.30pm weekdays (excluding Public Holidays)
Phone: (02) 6207 1923	TTY: (02) 6207 2622
Email: epdcustomerservices@act.gov.au	Website: www.environment@act.gov.au