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Declaration

General Form: Change of Contact Details

Fields marked with * are required

Collection statement

This information is collected by the SRO so we can update our records where your contact details have changed. If you do not provide the information required, we may not be able to contact you regarding your tax affairs. 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 on 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

Customer details

General Form: Change of Contact Details

Fields marked with * are required

Customer details

Are you an:

Individual

Company

Trust

Individual

First name

Middle name(s)

Family name

Date of birth

Company

Name

ABN

ACN

Trust

Name

ABN

ACN

SRO customer number

Mobile number

Phone number

Revenue lines the change applies to:

Land Tax

Payroll Tax

Growth Areas Infrastructure Contribution

Metropolitan Planning Levy

Land Transfer Duty

Unclaimed Money

Vacant Residential Land Tax

Other

Please specify

Is the form being completed by a customer or an authorised representative of the customer?

Customer

Representative

Please attach an authority from the taxpayer if you are not already listed as a contact for this account with the SRO. If this form is lodged without authority from the taxpayer that you can act on their behalf, the change of customer details cannot be processed.

I am attaching an authority (i.e. dated and signed letter of consent) from the customer.

Representative Authority

File:

Particulars of change

General Form: Change of Contact Details

Fields marked with * are required

Particulars of change

What change are you notifying us of:

Addition or amendment of authorised representative

Change of customer details

New representative details

First name

Middle name(s)

Family name

Company name (if applicable)

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

Mobile number

Phone number

The customer authorises the person listed above as the representative to interact with the SRO on customer's behalf.

The customer requests all future correspondence from the SRO regarding the revenue lines selected be addressed to the authorised representative.

Remove all previous authorised representative nominations.

All properties of which you are the owner or joint owner will be included in any future land tax assessment notices issued. By authorising a representative to receive your land tax correspondence, they will be privy to all the information contained within that correspondence.

Change of customer details

Change of name

First name

Middle name(s)

Family name

Name

Change of ABN/ACN

Name of company

New ABN

New ACN

Change of postal address

New 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

The change of address will remain valid until you formally notify the SRO of any subsequent change.

Change of contact details

New contact details

New mobile number

New phone number

New email

Change of contact person

New contact person

First name

Middle name(s)

Family name

Mobile number

Phone number

Summary

General Form: Change of Contact Details

Fields marked with * are required

Customer details

Are you an:

Individual

Company

Trust

Individual

First name

Middle name(s)

Family name

Date of birth

Company

Name

ABN

ACN

Trust

Name

ABN

ACN

SRO customer number

Mobile number

Phone number

Revenue lines the change applies to:

Land Tax

Payroll Tax

Growth Areas Infrastructure Contribution

Metropolitan Planning Levy

Land Transfer Duty

Unclaimed Money

Vacant Residential Land Tax

Other

Please specify

Is the form being completed by a customer or an authorised representative of the customer?

Customer

Representative

I am attaching an authority (i.e. dated and signed letter of consent) from the customer.

Representative Authority

File:

Particulars of change

What change are you notifying us of:

Addition or amendment of authorised representative

Change of customer details

New representative details

First name

Middle name(s)

Family name

Company name (if applicable)

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

Mobile number

Phone number

The customer authorises the person listed above as the representative to interact with the SRO on customer's behalf.

The customer requests all future correspondence from the SRO regarding the revenue lines selected be addressed to the authorised representative.

Remove all previous authorised representative nominations.

Change of customer details

Change of name

First name

Middle name(s)

Family name

Name

Change of ABN/ACN

Name of company

New ABN

New ACN

Change of postal address

New 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

The change of address will remain valid until you formally notify the SRO of any subsequent change.

Change of contact details

New contact details

New mobile number

New phone number

New email

Change of contact person

New contact person

First name

Middle name(s)

Family name

Mobile number

Phone number