Online registration form - NT property identification code (PIC)

Required fields are marked with an asterisk (*).

Date

Property name / holding (Please name eg  Smith farm, Smith block, Smith Springs, Smith Pastures etc)

Land details * (Pastoral lease # / NT portion # / section # / hundred of etc / street address)

Land owner details(as registered with Lands Titles Office)

Land owner's name (person/s)

or if owned by a company

ACN or ABN

Director/s

Land owner's postal address

Work phone

Home phone

Mobile

Fax

E-mail

Property / Residential details

• Manager
• Tenant/Renting
• Real Estate

Property manager's name

Postal address of property

Manager's mobile

Property telephone

Property fax

Manager’s E-mail

If Renting –

Real Estate agent name

Postal address of Real Estate agent

Real Estate agent’s telephone

Real Estate agent’s E-mail

Tenant-Renter’s name

Postal address of Tenant-Renter’s

Tenant-Renter’s mobile

Tenant-Renter’s E-mail

Livestock kept on the property (Advise number of head for each species of livestock. Horses include mules & donkeys. Poultry include chicken, turkeys, ducks, geese, guinea fowl etc)

Cattle

Comments

Beehives

Apiary details:

Type of operation:

• Honey producer
• Pollination
• Hobbyist
• Other

If other (please specify)

Apiary site details:

For more information or assistance in completing this form, email adele.kluth@nt.gov.au, Livestock Identification Systems Administrator (LISA) / Brands Biosecurity & Animal Welfare Group, Department of Primary Industry and Resources.