Wet Tropics Management Authority Yellow Crazy Ant Property

Wet Tropics Management Authority
Yellow Crazy Ant Property Information Form
Please Note that access to your property for treatment or surveillance will not include access to your residence without prior consultation.
Name of occupant/s
(First and Last Names)
Address of property
House number:
Street Name:
Lot number (if applicable):
Suburb:
Postcode:
RP number:
Contact details of occupant/s Please list more than one contact number if possible.
Home:
Work:
Email:
Mobile:
Consent to be contacted by email about program activities
Do you Rent or Own this property?
Occupancy
Expiry Date:
Name and address of property owner, or Agent if occupier not the owner of the property
Contact phone number:
Please indicate if you give permission for helicopter treatment up to 10 metres from your property.
Note: Helicopter will not fly over any buildings
It is essential that we are able to visit your property on a regular basis (likely three times per year over the next three
years), and we ask for your cooperation. Please let us know below if you need to be at home during surveillance
and treatment. Officers will be clearly identifiable and will not need to enter any house or building.
I understand that Wet Tropics Management Authority representatives may need to enter this property when I am
not home to inspect/treat my property for yellow crazy ants. However there are problems with access due to the
following reasons:
Please tick if you have:
Dog
Dangerous Dog
Horses
Livestock
Poultry/Caged birds
Industry
Cropping
Fish pond/s
Locked gates
Chemical sensitivity
Watercourse/dam
Mine
Forest/dense undergrowth
Dengue Mosquitoes
Please return this form by email [email protected] or post to PO Box 2050, Cairns Q 4870. If you have
any questions or would like more information please call Wet Tropics Management Authority on 42410500 or visit
www.wettropics.gov.au
Name:
Signature:
Date:
Privacy Statement: The Wet Tropics Management Authority is collecting the information on this form to assist the Yellow Crazy
Ant Eradication Program in surveillance and/or treatment of yellow crazy ants. This information will only be accessed by
authorised employees within the Authority. Your information will not be disclosed to any other parties unless authorised or
required by law.