Please resolve the following issues before proceeding

Click on an issue to go directly to the related section of the form.

errors found:

warnings found:

Declaration

GAIC: Application for GAIC Certificate

Fields marked with * are required

Receipt details

Your form has been successfully submitted. Please keep a copy of this acknowledgement for your records.

Reference number:

When contacting the State Revenue Office in relation to this application, please quote this Reference number.

Submission date and time:

To save or print a copy of the completed form and acknowledgement go to the "File" menu and select "Save as" or "Print".

Collection statement

This information is collected by the SRO so that we can issue you with a certificate showing the GAIC status of certain land. If you do not provide the information required, we may not be able to issue the certificate. The information collected may be used for the purposes of other SRO legislation. Where authorised by law to do so, we may also disclose this information to other government agencies including the ATO, State and Territory revenue offices and law enforcement agencies. You can find out more about how we use and protect your information in our Privacy Policy, available at www.sro.vic.gov.au

Declaration

I declare that I am authorised to make this declaration.

The information provided on this form and in any attached documents is complete and correct. I understand that penalties apply for giving false or misleading information or omitting information.

The Electronic Transactions (Victoria) Act 2000 establishes the regulatory framework for transactions to be completed electronically. This form requires you to complete an electronic signature via tick-box before lodgment. By ticking the box you indicate your approval of the contents of this electronic communication.

Date

Signature

Date (DD/MM/YYYY)

First name

Middle name(s)

Family name

Position (if applicable)

Organisation (if applicable)

Mobile number

Phone number

Applicant

GAIC: Application for GAIC Certificate

Fields marked with * are required

Is the applicant a business entity?

Individual

Business

Individual

Title

Other

First name

Middle name(s)

Family name

Business

Name of company

Trading name (if different from company name)

ABN

ACN

Postal address

Country

Australian address

What is the type of address?

Street

PO Box

Lot number

Floor/Level type

Floor number

Flat/Unit type

Unit number

PO Box number

Post office name

Lot number

Street number

Street name

Street type

Suburb/Town

State

Postcode

International address

Street address/Postal address

Suburb/Town

State

Postcode/Zipcode

Overseas Address

Contact

Mobile number

Phone number

Required details

GAIC: Application for GAIC Certificate

Fields marked with * are required

Details of the land

This information can be found on the Certificate of Title.

What is the type of address?

Street

Lot number

Floor/Level type

Floor number

Flat/Unit type

Unit number

Lot number

Street number

Street name

Street type

Suburb/Town

State

Postcode

Title

Volume

Folio

Lot

Plan

Plan type

Area of land (in hectares)

Municipality

Municipality property number

Section or portion number

Crown allotment

Parish/Township name

Do you have ownership (in full or part) in the land?

Yes

GAIC event

GAIC: Application for GAIC Certificate

Fields marked with * are required

Is there a GAIC event which has occurred, or is scheduled to occur in respect of the land?

Yes

GAIC certificate

A certificate will be provided for information purposes only.

GAIC event details

Indicate the GAIC event that is proposed to occur (or has occurred) in respect of the land:

Dutiable transaction

Significant acquisition

Subdivision

Building permit application

Per cent (%) of interest in the land to be acquired

Per cent (%) of interest in the landholder to be acquired

Date of GAIC event

Supporting documentation

GAIC: Application for GAIC Certificate

Fields marked with * are required

Supporting documents

Please provide documentation to support your GAIC application

File:

Declaration

Receipt details

Collection statement

Declaration

Applicant

Individual

Business