Changes to building and construction details

ORIGINAL BUILDING AND CONSTRUCTION WORK DETAILS

QLeave levy number *

Customer name *

Building and construction work description *

Building and construction work address *

Suburb *

State

ACTNSWNTQLDSATASVICWA

Postcode *

Which details would you like to change?

Please select all that apply.

• Lot/plan number
• Building and construction work description
• Owner
• Address
• Private certifier/council
• Start date
• Completion date
• Principal contractor

Lot/Plan number

To

From

Building and construction work description

To

From

Owner

To

From

Contact number

Contact email address

Address To

Address

Suburb

State

ACTNSWNTQLDSATASVICWA

Postcode

Address From

Address

Suburb

State

ACTNSWNTQLDSATASVICWA

Postcode

Private Certifier / Council

To

From

Contact number

Contact email address

Start date

To

From

Completion date

To

From

Principal contractor

To

From

Contact number

Contact email address

DECLARATION

I certify that the information provided is true and correct to the best of my knowledge. *

• Yes
• No

Name *

Company name

Contact Phone *

Email address *

Date