Notification of Change of Ownership/Management of an Authorised Plantation

This form is to be used by authorised plantation owners/managers, or their representatives, to notify changes to ownership or management of such plantations as required by Section 17A of the Plantations & Reafforestation Act 1999.

Person Requesting or Providing Information

First Name

Last Name

Organisation

Phone

Please use international dialing code, area code, and no spaces eg. +61200000000

Mobile

Please use international dialing code, area code, and no spaces eg. +61400000000

Plantation and Land Details

Authorisation Number (if known)

Name in which Authorisation was issued

Land to which application applies:

Lot:

e.g. Lot 6

DP:

e.g. DP 83314

Add another Lot/DP

Property Name (or State Forest Name)

Local Government Area (LGA)

Subject

Reason for Notification

Change in ownership of the whole of plantationChange in management of the whole of plantationChange in ownership of part/s of plantationChange in management of part/s of plantation

You can add multiple Owners/Managers below using the Add another Owner/Manager button at the bottom of the box.

New Owner/Manager Details

Position

OwnerManager

Entity

IndividualOrganisation

Lot:

e.g. Lot 6

DP:

e.g. DP 83314

Add another Lot/DP

First Name

Last Name

Organisation Name

ABN/ACN

If the named owner/manager is a business or company, please include the ABN/ACN of the registered business or corporation

Phone

Please use international dialing code, area code, and no spaces eg. +61200000000

Mobile

Please use international dialing code, area code, and no spaces eg. +61400000000

Mailing address details:

Street

Suburb

Postcode

State

Add another Owner/Manager

Nearest DPI Forestry Plantations Office is located at:

WollongbarCoffs HarbourMoss ValeAlbury

Plantation Certificate

A plantation certificate is provided for under the Plantations and Reafforestation Act 1999 to certify that a parcel of land contains an authorised plantation.

Would you like to make an application for a plantation certificate under section 68 of the Plantations and Reafforestation Act 1999?

YesNo

Would you like a copy of the plantation authorisation and map?

YesNo

Privacy Statement

All personal information collected from this form is subject to the Privacy and Personal Information Act 1998 (the Act). You should provide the information in order for NSW DPI to ensure our plantation records are accurate and up to date. NSW DPI may use the information and disclose it to other authorised agencies in accordance with the Act. The information may be pooled in a manner not identifying individuals to form industry based statistics. See our full privacy policy at www.regional.nsw.gov.au/privacy/privacy-management-plan.

I have read and agree to the Privacy Statement above.

I agree

I certify that all of the information provided is true and correct.

I agree