Online Form - Change of Name, Address & Email Form

If you've had a change of address, name or email address please use this form to update your details with the City. Please note that the "new email address" will be used to send you a confirmation of this form submission. 

Current Information


New Information


I am a... (please tick all of the relevant options)







Declaration

By ticking the "Yes, I Agree" box below you give permission for the City of Busselton to use this information to change the address/name details on all City managed systems. This form must be signed by the property owner, animal owner, creditor, debtor or applicant. If the property is owned jointly, property owner must sign. If signed by a power of attorney, a copy of the power of attorney must be provided. If executed by a company, the form must be executed in accordance with the Company’s constitution and the Corporations Act 2001 (C’wealth).

I Agree

 
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