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Contact Information for bushfire affected properties form

Property Details - (Affected property)
Contact Details
For the above property, I am the: *
Current contact address
(No white spaces and symbols are accepted)
(No white spaces and symbols are accepted)
Registered pets

When address details have changed, Council will contact you to update your details on the Companion Animal Register

Do you have any registered pets? *
Property details
How has your property been affected? More than one option may be selected
Other details
Authority * If required, do you consent to Hawkesbury City Council staff and/or their contractors to enter your site for purposes of assessment of risk AND to undertake 'make safe' work?
Some works on site may first require the permission from your insurance company. Please provide your Insurer details below so that Council may confirm their permission to enter the site, if required.

Privacy Notice

Council is bound by the provisions of the Privacy and Personal Information Protection Act 1998, in the collection, storage and utilisation of personal information provided in this form. Accordingly, the personal information will only be utilised for the purposes for which it has been obtained and may be available for public access and/or disclosure under various NSW Government legislation.

  • Intended recipients: The intended recipients of the personal information are Council officers.
  • Reason for collection: Council is collecting this information to record potential hazards that are used to inform the impact the assessment, make safe works, the rebuild process, fee concessions and donations.
  • Supply: The supply of information by you is voluntary.
  • Access and Correction: You may make an application to access or amend information held by Council.
  • Storage: Council is the agency that holds and controls the information.
  • Enquires: Contact the Privacy Information Officer at (02) 4560 4444 for any information enquiries.

Page ID: 141821

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