HOUSINGAPPLICATION FORM
DEVELOPING EAST ARNHEM
Section 1 – APPLICANT DETAILS, Note only employers can apply for housing
Full Name of
Company
ABN / ACN
Postal
Address
Contact
details
Name:
Telephone:
Mobile:
Email:
Section 2 – DETAILS OF BUSINESS ACTIVITY
Please
outline the
new
…………………………………………………………………………………………………..…….
economic
activity that is ...…………………………………………………………………………………………..................
driving the
need for this
…………………………………………………………………………………………………….…..
housing
Please
outline any
………………………………………………………………………………………………….……..
changes to
existing
...…………………………………………………………………………………………..................
activity that is
driving
………………………………………………………………………………………………….……..
housing
needs
Section 3 – DETAILS REQUIRED TO PROCESS APPLICATION
Please
A Total Nhulunbuy based workforce
provide the
following
B Number of houses currently owned and occupied by the business
detail
Outline
efforts made
to obtain
properties
from private
market
C
Number of houses rented from RTA, NTG or Commonwealth
E
Number of houses rented from other parties
F
Number of houses rented from the Development Corporation
G
Additional properties requested in this application
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
…………………………………………………………………………………………………….
Tenant
details
For the properties noted above, please note how many of these are held in the names of
employees versus the business:
Local
property
holdings
Will you reduce your private rental holdings in East Arnhem either prior to making this
appliction or as a result of being approved economic development corporation housing
YES
NO
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Information for applicants
Rio Tinto has committed to provide up to 250 properties to Developing East Arnhem.
A policy has been developed guiding access to these properties.
The guidelines that have been developed for these properties include:
 These property assets will be utilised to support existing or expanded economic activity in the region.
 The assets are to be income producing, with rents set at a level sufficient to cover costs and generate revenue
that will be directed to the corporation to support its wider economic development functions.
 Tenancy agreements will be with employers as housing will be available for those holding jobs in the
community.
 Employers will need to demonstrate that they have not reduced their private rental holdings prior to accessing
these properties.
 The application of these terms will be balanced against the goal of not limiting economic and population growth
in Nhulunbuy.
Note, tenancies may be entered into with Rio Tinto Alcan before being transferred to Developing East Arnhem.
Rental rates were established using an independent valuation. It is expected that market rates will be utilised over
time.
Confidentiality and privacy statement - The information collected on this form is to be used only for the purposes
of assessing eligibility for and allocating property assets to be transferred to the Development Corporation.. When
you give us personal information about another person or entity, you represent that you are authorised to do so and
agree to inform that person regarding the disclosure and the terms of this notice. Both local agents will be required
to comment on the application. These parties will be required to deal with this information sensitively. This step is
to protect local investors. Access to the information provided is restricted to the two local Agents and Rio Tinto
Alcan representatives involved in the management of housing stock You may seek to access, and/or correct any
errors in, your personal information held by the managing agent at any time in accordance with the Privacy Act
1988 (Cth). These records will not be accessible by members of the public. If you do not provide all information
sought in this form, or if false information is provided, your application will be ineligible and will not be processed.
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Section 4 – DECLARATION
THE NORTHERN TERRITORY OF AUSTRALIA
STATUTORY DECLARATION
_________________
(1) Insert full name
and address of
person
making
declaration
I,
……………………………………………………………………..
…………………………………………………………………………..
of
solemnly and sincerely declare that all information provided in this application is true and
correct.
This declaration is true and I know it is an offence to make a statutory declaration knowing it
is false in a material particular.
Declared at
the
day of
(2)
(2) Signature of the
person making the
declaration
(3) Signature of the
person
before
whom
the
declaration is made
20
..................................................................................... ...
(3)
Witnessed by:
......................................................................................
(4)
(4) Here insert full
name of person
before whom the
declaration is made,
legibly
written,
typed or stamped
......................................................................................
(5)
......................................................................................
(5) Here insert
contact address or
telephone number
of person before
whom
the
declaration is made
NOTE: This declaration may be witnessed by any person who is at least 18 (eighteen)
years of age.
NOTE: This written statutory declaration must comply with Part 4 of the Oaths
Affidavits and Declarations Act.
NOTE: Making a declaration knowing it is false in a material particular is an offence
for which you may be fined or imprisoned.
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SECTION 5 - OFFICE USE ONLY
EAST ARNHEM REAL ESTATE – Comments on application
………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………..
LJ HOOKER – Comments on Application
………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………..
To be completed on behalf of the Development Corporation:
This application has been assessed as to consistency with the present policy and is:
Supported

(please tick where applicable).
Not Supported

(please tick where applicable).
The following properties will be made available to the applicant:
4 Bedroom Houses
3 Bedroom Houses
2 Bedroom Flats
For and on behalf of Developing East Arnhem.
________________________________
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