SECTION A: Pre-application discussion It is recommended you discuss your application with DPI Water before submitting it. Have you had a pre-application discussion with DPI Water? (tick the appropriate box) No Go to Section B – A1 Yes - Answer A3 A5 A2 – If Yes The discussion took place on (specify date): A3 with the assistance of (specify name): A4 from the DPI Water office located at (specify office location): A5 SECTION B: Details of the original access licence Provide details of the co-held water access licence to be exited (the original access licence). Water access licence number: B1 Is there any money owed in relation to the original access licence, including water management B2 charges or civil penalties? No Yes - specify: Note: DPI Water cannot accept this application if there is any money owing for the original access licence. Do the co-holders hold the original access licence as joint tenants? B3 No Yes Note. DPI Water cannot accept this application if the original access licence is held by the co-holders as joint tenants. This restriction does not apply to an individual holding which is held by more than one person as joint tenants. SECTION C: Details of the holding/s to exit from the original access licence Specify the number of holdings to exit from the original access licence: (tick the appropriate box) C1 One (1) holding Go to Section D – More than one holding specify number: - Go to C2 – If you want more than one holding to exit from the original access licence, then for the purpose of C2 answering the questions in this application form you need to create a unique name to identify each holding (the holding identifier). or A, Holding B and Holding C’. For example, ‘John Smith’s holding’; ‘Holding Specify a holding identifier for each holding to exit from the original access licence: 1. 2. 3. Note: If you are applying for more than three holdings to exit from the original access licence, you can add more holding identifiers to this list.
SECTION A: Pre-application discussion It is recommended you discuss your application with DPI Water before submitting it. Have you had a pre-application discussion with DPI Water? (tick the appropriate box) A1 No – Go to Section B A2 Yes - Answer A3 – A5 If Yes A3 The discussion took place on (specify date): A4 with the assistance of (specify name): A5 from the DPI Water office located at (specify office location): SECTION B: Details of the original access licence Provide details of the co-held water access licence to be exited (the original access licence). B1 Water access licence number: B2 Is there any money owed in relation to the original access licence, including water management charges or civil penalties? No Yes - specify: Note: DPI Water cannot accept this application if there is any money owing for the original access licence. B3 Do the co-holders hold the original access licence as joint tenants? No Yes Note. DPI Water cannot accept this application if the original access licence is held by the co-holders as joint tenants. This restriction does not apply to an individual holding which is held by more than one person as joint tenants. SECTION C: Details of the holding/s to exit from the original access licence C1 Specify the number of holdings to exit from the original access licence: (tick the appropriate box) One (1) holding – Go to Section D More than one holding – specify number: - Go to C2 C2 If you want more than one holding to exit from the original access licence, then for the purpose of answering the questions in this application form you need to create a unique name to identify each holding (the holding identifier). For example, ‘John Smith’s holding’; or ‘Holding A, Holding B and Holding C’. Specify a holding identifier for each holding to exit from the original access licence: 1. 2. 3. Note: If you are applying for more than three holdings to exit from the original access licence, you can add more holding identifiers to this list.