PERMIT HOLDER DETAILS Name of Organisation or Individual: Name of Primary Contact: Contact Number: Permit Number: Activity Type: PERMIT ACTIVITY USAGE FIGURES Non-Commercial/Club Permits: Please record all regular usage and events in the table below. Commercial Permits: Usage fees apply. The figures reported in this table will allow Forestry Corporation to develop an understanding of the type and amount of recreational activities undertaken in our State Forests. Please list all events undertaken within your Forest Permit for the quarter specified. Quarter: Agreed Usage Fee: (e.g. January to March 2017) Number of Club Event* Location Date Event Name / Reference Participants Yes / No (e.g. State Forest Name/s) * Club Events excludes State, Interstate, National, International and Commercial events. DECLARATION I/we declare that the information provided is correct to the best of my/our understanding. Name: Signature: Date:
PERMIT HOLDER DETAILS Name of Organisation or Individual: Name of Primary Contact: Contact Number: Permit Number: Activity Type: PERMIT ACTIVITY USAGE FIGURES Non-Commercial/Club Permits: Please record all regular usage and events in the table below. Commercial Permits: Usage fees apply. The figures reported in this table will allow Forestry Corporation to develop an understanding of the type and amount of recreational activities undertaken in our State Forests. Please list all events undertaken within your Forest Permit for the quarter specified. Quarter: (e.g. January to March 2017) Agreed Usage Fee: Date Location (e.g. State Forest Name/s) Event Name / Reference Number of Participants Club Event* Yes / No * Club Events excludes State, Interstate, National, International and Commercial events. DECLARATION I/we declare that the information provided is correct to the best of my/our understanding. Name: Signature: Date: