Form 77 - Amalgamate take and use water and operate works licences

Form 77 - Take and use water and operate works licensing - Amalgamate

Application to amalgamate take and use water and operate works licences.

Lands must be contiguous for licences to be amalgamated. You cannot proceed if the lands are non-contiguous.

Please read this information in detail prior to completing this form (opens in a new window)

Please note that if more than 6 signatures are required per group (e.g. Owners, Licensees, Sellers, Buyers, Transferees) please contact GMW to request an offline form.

Applicant details

Please note that all communication related to this form will be directed to the Applicant or Lodging Party.

The Applicant is the person who is submitting the application to GMW, they are the main contact for that form submission and are responsible for the information being submitted and the coordination of e-signatures and payment of the application fee.

The Applicant may be a lodging party/ solicitor/ conveyancer/ water broker but can also be a new or existing customer submitting their own application form as  the seller/buyer or licensee.

If the property transferring includes a general place of take and/or extraction share, this will be included on the application form

Every application requires an “applicant”.

This email address will receive all automated correspondence in relation to this form submission.
Postal address
Application details
Licence Type This is a required field.
Licence Type This is a required field.
LICENCE 1

If more than 6 signatures are required, please contact GMW to request an offline form.

Applying as a company

Please note when applying as  a company:

  • The form must be signed by those persons duly authorised to sign on behalf of the company in accordance with section 127(1) of the Corporations Act 2001; two directors, alternatively one director and one secretary, unless there is a sole director and secretary of the company.
  • A current (less than 12 months old) copy of an ASIC Company Search listing all directors and/or office bearers must be provided.

You can obtain a Company Extract by:

  • Accessing the internet service at www.asic.gov.au (opens in a new window) or by phoning (03) 5177 3988
  • Contacting your solicitor or legal advisor to conduct the search on your behalf (fees may apply)
  • Requesting that GMW complete the searches on your behalf (fees apply)

You must provide the details of those persons duly authorised to sign on behalf of the company.

Licence 1 - Licensee 1
Applicant is Licence 1 - Licensee 1 This is a required field.
Applicant is Licence 1 - Licensee 1 This is a required field.
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address
Licence 1 - Licensee 2
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as Licensee 1? This is a required field.
Postal address is the same as Licensee 1? This is a required field.
Postal address
Licence 1 - Licensee 3
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as Licensee 2? This is a required field.
Postal address is the same as Licensee 2? This is a required field.
Postal address
Licence 1 - Licensee 4
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as Licensee 3? This is a required field.
Postal address is the same as Licensee 3? This is a required field.
Postal address
Licence 1 - Licensee 5
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as Licensee 4? This is a required field.
Postal address is the same as Licensee 4? This is a required field.
Postal address
Licence 1 - Licensee 6
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as Licensee 5? This is a required field.
Postal address is the same as Licensee 5? This is a required field.
Postal address
LICENCE 2

If more than 6 signatures are required, please contact GMW to request an offline form.

Applying as a company

Please note when applying as  a company:

  • The form must be signed by those persons duly authorised to sign on behalf of the company in accordance with section 127(1) of the Corporations Act 2001; two directors, alternatively one director and one secretary, unless there is a sole director and secretary of the company.
  • A current (less than 12 months old) copy of an ASIC Company Search listing all directors and/or office bearers must be provided.

You can obtain a Company Extract by:

  • Accessing the internet service at www.asic.gov.au (opens in a new window) or by phoning (03) 5177 3988
  • Contacting your solicitor or legal advisor to conduct the search on your behalf (fees may apply)
  • Requesting that GMW complete the searches on your behalf (fees apply)

You must provide the details of those persons duly authorised to sign on behalf of the company.

Licence 2 - Licensee 1
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address
Licence 2 - Licensee 2
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as Licensee 1? This is a required field.
Postal address is the same as Licensee 1? This is a required field.
Postal address
Licence 2 - Licensee 3
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as Licensee 2? This is a required field.
Postal address is the same as Licensee 2? This is a required field.
Postal address
Licence 2 - Licensee 4
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as Licensee 3? This is a required field.
Postal address is the same as Licensee 3? This is a required field.
Postal address
Licence 2 - Licensee 5
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as Licensee 4? This is a required field.
Postal address is the same as Licensee 4? This is a required field.
Postal address
Licence 2 - Licensee 6
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as Licensee 5? This is a required field.
Postal address is the same as Licensee 5? This is a required field.
Postal address
Additional information

Please provide any further details, if any, related to your property or ownership.

DETAILS OF THE NEW AMALGAMATED LICENCE

All land parcels, works, rates, use type and volumes included on the nominated Licences will be combined in the amalgamated Licence.

Lands must be contiguous for licences to be amalgamated. You cannot proceed if the lands are non-contiguous.

List the Bore or Pump or Service Point Number with the Proposed Extraction Rate (ML/Day), Volume Requested and Use Type as Bore/Pump/Service Point Number / Proposed Extraction Rate (ML/Day) / Volume Requested / Use Type.

If applicable, attach a signed and witnessed Statutory Declaration stating the properties are being operated as a single farming and financial enterprise.

Land Ownership This is a required field.
Land Ownership This is a required field.
New licence holder(s)

If more than 6 signatures are required, please contact GMW to request an offline form.

Applying as a company

Please note when applying as  a company:

  • The form must be signed by those persons duly authorised to sign on behalf of the company in accordance with section 127(1) of the Corporations Act 2001; two directors, alternatively one director and one secretary, unless there is a sole director and secretary of the company.
  • A current (less than 12 months old) copy of an ASIC Company Search listing all directors and/or office bearers must be provided.

You can obtain a Company Extract by:

  • Accessing the internet service at www.asic.gov.au (opens in a new window) or by phoning (03) 5177 3988
  • Contacting your solicitor or legal advisor to conduct the search on your behalf (fees may apply)
  • Requesting that GMW complete the searches on your behalf (fees apply)

You must provide the details of those persons duly authorised to sign on behalf of the company.

New Licence Holder 1
Type
Type
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address
New Licence Holder 2
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as New Licence Holder 1? This is a required field.
Postal address is the same as New Licence Holder 1? This is a required field.
Postal address
New Licence Holder 3
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as New Licence Holder 2?
Postal address is the same as New Licence Holder 2?
Postal address
New Licence Holder 4
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as New Licence Holder 3? This is a required field.
Postal address is the same as New Licence Holder 3? This is a required field.
Postal address
New Licence Holder 5
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as New Licence Holder 4? This is a required field.
Postal address is the same as New Licence Holder 4? This is a required field.
Postal address
New Licence Holder 6
Type This is a required field.
Type This is a required field.
Company details

Please see notes above on applying as a company.

Company Extract This is a required field.
Company Extract This is a required field.
Contact details
Postal address is the same as New Licence Holder 5? This is a required field.
Postal address is the same as New Licence Holder 5? This is a required field.
Postal address
Details of the land(s) on which the works are located and water is to be taken and used

Volume / Folio / Lot No / Plan No / Crown Allotment / Section / Parish

Details of the new licence to be issued after the subdivision

Please list the Works No | Proposed Extraction Rate (ML/day) | Volume Requested (ML/year) | Use Type for each of the works. The total Volume Requested must equal the volume listed for Assignee Ref No 2 above.

Declarations
Declaration 1 This is a required field.
Declaration 1 This is a required field.
Declaration 2 This is a required field.
Declaration 2 This is a required field.
Signatures
  • When you submit this form, invitation emails will be sent to all signatories requesting that they review and sign your submission
  • You will be notified each time a signature has been submitted
  • You will receive a request for payment (if applicable) when the final signature has been submitted

If you are signing this form and not representing a company, please enter N/A in Position.

Licence 1 - Licensee 1 Sign Here
Sign Here
Payment
Save draft

Please ensure that the information provided in this form is correct as it cannot be modified after it is submitted.

If needed, you are able to save a draft and come back to the form via a link that will be emailed to you.

Submit

 

Protecting your privacy

Goulburn-Murray Water (GMW) protects your privacy by collecting and handling your personal information in accordance with the requirements of the Privacy & Data Protection Act 2014. Your personal information is collected on this form and will be used for the purpose of administering this application, updating our records and updating the Victorian Water Register (if applicable). Information collected is usually disclosed to staff involved in processing your application, contractors, connection staff, other relevant GMW staff and government departments. Failure to provide the information sought may result in processing delays or non acceptance of your application. It may also limit our ability to be able to provide various programs or services. You may gain access to and correct your personal information. For further information please refer to our Privacy Policy at www.g-mwater.com.au or call 1800 013 357 to obtain a copy of this policy.