Registered water entitlement declaration holder/s’ All of the following parties must complete and sign in the appropriate sections of the declarations (sections 5.9, 5.10 and 5.11): applicants registered water entitlement holders registered owners of the land. DNRM requires that persons or, if a corporation, representatives sign all applicable parts of the declaration. Where the same person or corporation is more than one party (e.g. applicant and registered water entitlement holder), the person or representatives must sign for each party (e.g. the applicant declaration and registered water entitlement holder declaration). Registered water entitlement holder/s declaration By signing this form you: confirm all details in this application pertaining to the water entitlement/s in which you have an interest are true and accurate consent to the project proposed in this application including, if applicable, the transfer of any nominated water in which you have an interest acknowledge information provided in this form will be used for the purposes outlined in the privacy statement at section 7 of this form consent to the disclosure of water entitlement/s information to the Australian Government (or its solicitors) so that legal due diligence may commence should the application be approved. This consent includes, but is not limited to the number and security of the water entitlement/s, the ownership of the water entitlement/s, any associated landholdings and title references, any water usage, temporary transfers and allocation held by or accruing to the water entitlement, any third party interests, any water deficit, any financial or other liabilities and copies of any notices. Completing this form does not guarantee the applicant funding under the project. If a person Name Name ABN ABN Signature Signature Date Date Witness Witness Signature Signature Date Date If a corporation Executed on behalf of ACN Name Name Position/title Position/title Signature Signature Date Date Witness Witness Signature Signature Date Date  Please attach Please copy this page and attach an additional sheet if more space is required.
Registered water entitlement holder/s’ declaration All of the following parties must complete and sign in the appropriate sections of the declarations (sections 5.9, 5.10 and 5.11): applicants registered water entitlement holders registered owners of the land. DNRM requires that persons or, if a corporation, representatives sign all applicable parts of the declaration. Where the same person or corporation is more than one party (e.g. applicant and registered water entitlement holder), the person or representatives must sign for each party (e.g. the applicant declaration and registered water entitlement holder declaration). Registered water entitlement holder/s declaration By signing this form you: confirm all details in this application pertaining to the water entitlement/s in which you have an interest are true and accurate consent to the project proposed in this application including, if applicable, the transfer of any nominated water in which you have an interest acknowledge information provided in this form will be used for the purposes outlined in the privacy statement at section 7 of this form consent to the disclosure of water entitlement/s information to the Australian Government (or its solicitors) so that legal due diligence may commence should the application be approved. This consent includes, but is not limited to the number and security of the water entitlement/s, the ownership of the water entitlement/s, any associated landholdings and title references, any water usage, temporary transfers and allocation held by or accruing to the water entitlement, any third party interests, any water deficit, any financial or other liabilities and copies of any notices. Completing this form does not guarantee the applicant funding under the project. If a person Name Name ABN ABN Signature Signature Date Date Witness Witness Signature Signature Date Date If a corporation Executed on behalf of ACN Name Name Position/title Position/title Signature Signature Date Date Witness Witness Signature Signature Date Date  Please attach Please copy this page and attach an additional sheet if more space is required.