Small business and NGO declaration

Small business and NGO declaration

Please complete the below form to lodge a crown lessee, small business or not-for-profit declaration.
Name: *
Email: *
Phone number:
Position: *
Business name: *
Business type: *
Which applies to you: *

Crown lessee Not-for-profit Small business
ABN: *
Customer number: *
What is the permitted land use pursuant to your lease: *
Type of lease: *

Western Australian Planning Commission Pastoral Diversification Permit Fremantle Crown land Whiteman Park
Lease / Permit number: *
Reason for request: *
Upload any supporting information:

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Cancel of
Declaration:

Yes
By submitting this form, I declare that the information contained within is correct and accept that false information supplied will result in a refusal of the rent waiver support. I will advise the Department should my business circumstances change.
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