Suite 30, Level 1, 64 Victor Crescent, Narre Warren 3805/ PO BOX 297, Webb Street LPO, Narre Warren 3805
Telephone: 1300 764 186 / Email: [email protected] / Website: www.dpcullen.com.au
AUTHORITY TO ACT AS AGENT
I/WE..............................................................................................................................................(owner(s))
Of (current address).............................................................................................................................
Phone Number………………………………Email…………………………………………………………
being the owner(s) of land known as
Lot No..................Street No.......................
Street, Road, etc.............................................................
Suburb..................................................................................Post Code.............................................
do hereby give my/our consent to (Agent) ………………………………………………..
Of (current address).............................................................................................................................
Phone Number………………………………Email…………………………………………………………
to act as my/our agent with respect to the proposed works at the above mentioned property in relation to
to the lodgement of documents, making any applications, appeals or referrals required by legislation
and/or obtaining any information as may be deemed necessary in relation to the proposed works.
Dated this.............................................day of.....................................................20..........................
Owner(s) Signature...........................................................................................................................
Agents Signature...............................................................................................................................
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