Request for Access to Online Services by lindayy


Request for Access to Online Services

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									Request for Access to Online Services
     Individual access, no company: Please complete Steps 1, 4 and 5 only                              Reset Form

     Individual access with company access: Please complete all steps

Step 1: Individual Details:
First Name:                                            Email address:

Last Name:                                             Phone Number:

Postal Address:                                        Mobile Number:


State:          Postcode:

Step 2: Company Details:
Company Name:                                          ACN/ABN:(Mandatory)

Company Email Address:                                 Phone Number:

Postal Address:                                        Applicant’s position in company:(Mandatory)

                                                       Director's Name: (Mandatory)

State:          Postcode:

Step 3: Company Administrator (Company access only)
The Company Administrator will have the ability to control access to the Company’s projects, add individuals to the
company and manage Company logon details.

Name of nominated Company Administrator: (if known)

First name:                                          Last name:

Step 4: Proof of Identity
I have provided the following to the Authority in support of this application:
     Written authorisation signed by a Director on Company letterhead:
     (Required only if person applying is not a company director)

     Photographic identification (e.g. drivers licence)
Online Services - Terms and Conditions

The ACT Planning and Land Authority (the Authority) grants you a non-exclusive licence to
reproduce the contents of this website for the sole purpose of viewing the content, and
where authorised, to upload required documentation for official business purposes.

The contents of the Authority’s website and downloadable material are subject to copyright.
For further information please refer to the Copyright Act 1968 (Commonwealth).

You agree that you will not divulge your user name password to provide or facilitate direct
online access to third parties for any purpose.

The Authority does not guarantee that your access to this site will be uninterrupted. There
may be interruptions to services to facilitate urgent and reasonable maintenance.

The Authority will not be liable to you or third parties for any loss, damage or injury arising
from attempted use of this site by users, or resulting from interruptions to the service
beyond our control including, but not limited to, problems with your user or access to:

    •   Telecommunications services;
    •   Internet service provider; or
    •   Hardware or software, except to the extent, if any, which we may not be able to
        lawfully exclude such liability.

If the Authority finds that you are using the site inappropriately, the Authority may restrict
or terminate your access immediately, and if necessary take legal action.

The personal information on this form is being collected to enable processing of your
application. Collection of personal information is authorised by Chapters 7, 8 and 9 of the
Planning and Development Act 2007. The information that you provide may be disclosed to
the ACT Revenue Office and the Office of Regulatory Services. The information may be
accessed by other government agencies, ActewAGL, ACTEW Corporation and other commercial
organisations interested in development and building information. The Planning and
Development Act 2007 requires the details of applications, decisions and orders to be kept
on a register and made available for public inspection. Information and documentation
relevant to a development application may be made available via the Internet.

Step 5: Declaration
I declare that:
         I am an authorised representative of this Company (if applicable)
         I have read and agree to the Terms and Conditions for Online Services

Applicant Name:

Applicant Signature:           Please press, print and sign        Date:        /200
                                                                             / Reset form

ACTPLA Admin Only

    Online Access granted

    Online Access refused/not required

Actioning staff initial:                      Date:    /   /200

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