Fcs-024 - Property Enquiry Application Form
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1Printed: Wednesday, 25 November 2015
FCS-024
Property Enquiry Application Form
PROPERTY DETAILS
REGISTERED PROPRIETOR IF NOT VENDOR
Property no: __________________________________
Name: ______________________________________
Street: _______________________________________
Street: ______________________________________
Town: ______________________ Post Code: _______
Town: _______________________ Post Code: _______
Note: Generally replies will be emailed to applicant’s
email address.
VENDORS SOLICITOR
Water Information Statement: Available five working days
after the receipt of application. Payment of $49.15 to be
Name: ______________________________________
made before application can be processed.
Special Meter Reading: Available 48 working hours after
Street: ______________________________________
the requested date. Payment of $25.10 to be made
before application can be processed.
Town: _______________________ Post Code: _______
VENDOR
APPLICANT’S NAME AND ADDRESS
Name: _______________________________________
Name: ______________________________________
Street: _______________________________________
Street: ______________________________________
Town: ______________________ Post Code: _______
Town: _______________________ Post Code: _______
PURCHASER
APPLICANT’S REFERENCE
Name: _______________________________________
Applicant reference number: _____________________
Street: _______________________________________
Total Sale Price: $ _____________________________
Town: ______________________ Post Code: _______
Auction/ Settlement Date: _______________________
Applicant’s Telephone Number: ___________________
SPECIAL METER READING DATE
(conducted on Tuesday
& Friday only – information available in 48 hours.)
Applicant’s Fax Number: ________________________
Date: ________________________________________
Email: ______________________________________
AUTHORITY
TBC
South Gippsland Water
Street: ______________________________________
PO box 102
Foster VIC 3960
Town: _______________________Post Code: _______
Ph: 03 5582 0444
Fax: 03 5682 1199
Lot No./Plan No. _______________________________
Email:
.au
Municipality __________________________________
Additional References or Comments – State whether
vacant land or nature of building (e.g. Dwelling):
PAYMENT DETAILS:
Card Number:
☐
☐
Total $
Visa
MasterCard
Expiry
/
CCV:
X
X
Cardholders name:
Approved: 01/07/2015
Customer Service
Page 1 of 1
Revision: 02.1
FCS-024 - Property Enquiry Application Form
HPRM: 101/002/001
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Parent category: Business