APPLICATION FOR CONSENT TO TRANSFER A NATIONAL PARK SHACK LEASE

1. This form is to be used to apply for consent to transfer a national park shack lease pursuant to section 35 of the National Parks and Wildlife Act 1972. It is best completed via a desktop with a modern browser.

2. Submission of this form requires payment of $510.00 (GST exempt) by MasterCard or Visa (please note application fees may not be refundable). Other application form and payment options are available.

3. Please note that annual fees also apply for national park shack leases.

4. On approval, a lease is an exclusive right to occupy the leased portion of land.

5. Please contact DEWShacks@sa.gov.au regarding life tenure shack leases as this form is not applicable for life tenure leases issued pursuant to section 78B of the Crown Lands Act 1929.

6. The information provided on this form may be used in accordance with the Government of South Australia's Information Privacy Principles. You are encouraged to read the Department for Environment and Water's Privacy Statement.

7. Please email the Crown Lands Program or phone 8429 7680 if you require any assistance.

Lease details

National park name *

Lease number *e.g. PK051234

Shack site number *

Current lease holder details (Transferor)

Please note - the names provided below must match the names recorded on the current lease.

Title

First name *

Middle name(s)

Last name *

Postal address *

Suburb/Town *

State *

Postcode *

Email *If no email address, please type no@email.com

Contact phone number *

Are there any other transferors? *

YesNo

Title

First name *

Middle name(s)

Last name *

Postal address *

Suburb/Town *

State *

Postcode *

Email

Contact phone number *

Are there any other transferors? *

YesNo

Title

First name *

Middle name(s)

Last name *

Postal address *

Suburb/Town *

State *

Postcode *

Email

Contact phone number *

Are there any other transferors? *

YesNo

Please complete an Additional applicants form and save it to your desktop/USB, etc. Click Browse below and locate the saved form to upload it to this application.

Additional applicants form upload

Browse

All current lease holders are required to sign the Authorisation form for consent to transfer a national park shack lease. Click Browse below and locate the completed form to upload it to this application.

Authorisation form *

Browse

Proposed lease holder details (Transferee)

Title

First name *

Middle name(s)

Last name *

Postal address *

Suburb/Town *

State *

Postcode *

Email *If no email address, please type no@email.com

Contact phone number *

Are there any other transferees? *

YesNo

Title

First name *

Middle name(s)

Last name *

Postal address *

Suburb/Town *

State *

Postcode *

EmailIf no email address, please type no@email.com

Contact phone number *

Are there any other transferees? *

YesNo

Title

First name *

Middle name(s)

Last name *

Postal address *

Suburb/Town *

State *

Postcode *

EmailIf no email address, please type no@email.com

Contact phone number *

Are there any other transferees? *

YesNo

Please complete an Additional applicants form and save it to your desktop/USB, etc. Click Browse below and locate the saved form to upload it to this application.

Additional applicants form upload

Browse

Proposed tenancy type *

See glossary for explanations of tenancy types.

All current lease holders are required to sign the Authorisation form for consent to transfer a national park shack lease. Click Browse below and locate the completed form to upload it to this application.

Authorisation form *

Browse

Additional details

Has a settlement date been scheduled? *

YesNo

Settlement is scheduled for *Crown Lands requests that applications are submitted 4 weeks prior to settlement.

Please provide details below if a conveyancer/legal practitioner is managing the transfer.

Title

First name

Last Name

Legal/Business Name

Email address

Contact phone number

Click Browse below to locate any additional information on your desktop/USB, etc that you wish to upload to this application.

Browse

Please provide any other information relevant to this application

Declaration

Full name of person submitting form *

Email address *

Date *

•I declare that the information stated within this application is true and correct *

•I declare that all parties named on this form agree to the transfer of the lease *

Payment details

Payment *

Receipt Number

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