APPLICATION TO TRANSFER A CROWN LAND LICENCE

1. This form is to be used to apply for the transfer of a Crown land licence pursuant to section 50 of the Crown Land Management Act 2009. It is best completed via a desktop using 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 Crown land licences.

4. 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.

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

Crown land details

For information about how to obtain land details refer to South Australian property and planning atlas.

Title reference

Volume number

Folio number

Parcel type

Parcel number

Plan type

Plan number

Hundred name

Street address

Location (Suburb/Town)

Are there additional land parcels? *

YesNo

Title reference

Volume number/Folio number

Land descriptionSection/Allotment, Plan type, Plan number

Current licence details

Licence prefix *

Licence number (6 digits) *

Licence purpose(s)

Are there any extra uses of the licensed land (current or proposed) that are not included in the licence purposes? *

YesNo

Extra purpose(s) - please provide details including whether development approval is required for any proposed purposesA licence amendment may also be required during, or following, the licence transfer

Click Browse below and upload any information about extra uses of the land (current or proposed) from your desktop/USB, etc to this application.

Extra purpose upload

Browse

Is this licence associated with land in private ownership? *

Yes No

Title reference

Volume number

Folio number

Is additional private land associated with this licence? *

Yes No

Title reference

Volume number

Folio number

Is additional private land associated with this licence? *

Yes No

Title reference

Volume number

Folio number

Is additional private land associated with this licence? *

Yes No

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

Additional land parcel form upload

Browse

Is this an underlease? *

YesNo

Lease number

Shack site number

Area commonly known as

Other area (ie. not in dropdown list)

Submitter details

Title

First name *

Middle name (s)

Last name *

Email address *

Contact phone number *

Are you a registered conveyancer/legal practitioner submitting this application on behalf of other parties and the point of contact for this application? *

Yes No

I have verified the identity of my clients *

Yes No

I confirm that I have the 'right to deal' for the other parties *

YesNo

Business name

Current licence holder details (Transferor)

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

Transferor type *

Title

First name *

Middle name(s)

Last name *

Legal/Business name *

ABN

ACN

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

Transferor type

Title

First name *

Middle name(s)

Last name *

Legal/Business name *

ABN

ACN

Postal address *

Suburb/Town *

State *

Postcode *

Email

Contact phone number *

Are there any other transferors? *

YesNo

Transferor type

Title

First name *

Middle name(s)

Last name *

Legal/Business name *

ABN

ACN

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

Proposed licence holder details (Transferee)

Please note - the names provided below must match those on the certificate of title (if relevant)

Transferee type *

Title

First name *

Middle name(s)

Last name *

Legal/Business name *

ABN

ACN

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

Transferee type *

Title

First name *

Middle name(s)

Last name *

Legal/Business name *

ABN

ACN

Postal address *

Suburb/Town *

State *

Postcode *

Email

Contact phone number *

Are there any other transferees? *

YesNo

Transferee type *

Title

First name *

Middle name(s)

Last name *

Legal/Business name *

ABN

ACN

Postal address *

Suburb/Town *

State *

Postcode *

Email

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

Additional details

Please add any other information relevant to this application

Declaration

Full name of person submitting form *

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 licence *

•I declare that the proposed licence holder(s) is/are at least eighteen years of age and have legal capacity and legal authority to enter into a legal agreement with the Minister for Climate, Environment and Water. *

Payment details

BpointPayment *

Receipt Number

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