Fillable Commercial sublease application form (Department of the Prime Minister and Cabinet)

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Commercial sublease application form (Department of the Prime Minister and Cabinet)

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Commercial sublease application form
This application form is to be completed by businesses seeking to enter into a commercial Sublease with the
Office of Township Leasing to operate within an Aboriginal Township in the Northern Territory.
A signed and completed application form.
A copy of your Certificate of Incorporation and Constitution (if applicable)
Any documentation that there is broad support for the proposed business activity from the Township’s
residents
A signed and completed consent form to allow a credit check on the applicant business and all proposed
personnel
Signed and completed consent form to allow police checks on the applicant business, any person
concerned in the management of the business and all proposed personnel, including a national police
record check from a Relevant Authority to determine whether a person has been convicted of a Sexual or a
Crime against Children Offence.
Copy of your business plan (if applicable)
Applicant checklist
About the Office of Township Leasing
The position of Executive Director, Township Leasing (EDTL) has been established to enter into and administer Township
Leases on Aboriginal land in the Northern Territory. Township Leasing enables Aboriginal land owners to issue long term
leases over their land to allow more normalised land tenure arrangements and to promote economic development.
Among other things, the functions of the Executive Director are:
• to enter into, on behalf of the Commonwealth, leases under section 19A of the Aboriginal Land Rights (Northern
Territory) Act;
• to administer leases and subleases and other rights and interests derived from such leases, in accordance with their
terms and conditions; and
• to perform any other functions that are prescribed by the regulations, related to the above two functions.
About this form
This form is designed to help organisations either seeking to establish a business, or significantly change an existing
business, to explain to the EDTL the nature of the business proposal to enable the office to make a preliminary
assessment about the suitability and viability of the of the business for the community. From this preliminary
assessment the EDTL will contact the applicant for further discussion/information which may include a requirement to
provide a more detailed proposal which may include a requirement for a business plan together with more detailed
financial information.
How to complete this form
Please complete all fields contained in the application.
If you require assistance completing this form please contact the Office of Township Leasing
Enquiries and Sublease Applications should be directed to
Office of Township Leasing
GPO Box 3671
Darwin NT 0801
Ph: 1800 152 259
E: townshipleasing@otl.gov.au
1. Applicant Information
Business name:
Name of the business making the application for a
commercial sublease in the township.
ABN:
11 digit Australian Business Number.
What type of organisation are you? Are you Incorporated: Are you Registered for use:
Sole trader/Partnership
Company
Yes No
Contact Person:
Address:
Name:
Position:
Street:
Town/suburb:
State/Territory:
Postcode:
Telephone:
Business hours:
Mobile:
Fax:
Email:
2. Proposed Term
Proposed term of the sublease: Term in years:
3. Proposed Aboriginality
The EDTL has a duty to make reasonable efforts to ensure that Sub-lessee’s are familiar with and show respect for
Aboriginal Tradition as it applies to the land. The following questions are designed to establish whether the applicant has
an existing connection with the community and if not whether they have an understanding of the nature of operating a
business within an Aboriginal Township.
Is the applicant:
An Aboriginal or Torres Strait Islander with connection to the relevant Township?
Please provide details
An Aboriginal or Torres Strait Islander who does not have connection to the relevant Township?
Please provide details
Not an Aboriginal or Torres Strait Islander but with connection to the relevant Township?
Please provide details
Not an Aboriginal or Torres Strait Islander who does not have connection to the relevant Township?
Yes No
4. Applicants Details
Person 1
Full name:
_____________________________________________
Role in proposed business:
Date of birth: _________________________________
Drivers licence number: _________________________
Current Address:
Has this person ever been convicted of a criminal
offence against a child?
Yes No
If yes please provide details:
_____________________________________________
Has this person signed and completed consent
form to allow police checks including a national
police record check from a Relevant Authority to
determine whether a person has been convicted of
a Sexual or a Crime against Children Offence.
Yes No
Please detail this persons proposed role in the
business and their experience in a similar role:
_____________________________________________
Person 2
Full name:
_____________________________________________
Role in proposed business:
Date of birth: _________________________________
Drivers licence number: _________________________
Current Address:
Has this person ever been convicted of a criminal
offence against a child?
Yes No
If yes please provide details:
_____________________________________________
Has this person signed and completed consent
form to allow police checks including a national
police record check from a Relevant Authority to
determine whether a person has been convicted of
a Sexual or a Crime against Children Offence.
Yes No
Please detail this persons proposed role in the
business and their experience in a similar role:
_____________________________________________
_____________________________________________
4. Applicants Details
Person 3
Full name:
_____________________________________________
Role in proposed business:
Date of birth: _________________________________
Drivers licence number: _________________________
Current Address:
Has this person ever been convicted of a criminal
offence against a child?
Yes No
If yes please provide details:
_____________________________________________
Has this person signed and completed consent
form to allow police checks including a national
police record check from a Relevant Authority to
determine whether a person has been convicted of
a Sexual or a Crime against Children Offence.
Yes No
Please detail this persons proposed role in the
business and their experience in a similar role:
Person 4
Full name:
_____________________________________________
Role in proposed business:
Date of birth: _________________________________
Drivers licence number: _________________________
Current Address:
Has this person ever been convicted of a criminal
offence against a child?
Yes No
If yes please provide details:
_____________________________________________
Has this person signed and completed consent
form to allow police checks including a national
police record check from a Relevant Authority to
determine whether a person has been convicted of
a Sexual or a Crime against Children Offence.
Yes No
Please detail this persons proposed role in the
business and their experience in a similar role:
5. Site Details
Township:
Please identify the relevant township that the sublease application is for.
Proposed premises
Please note the Sublessee is generally not permitted to undertake any development or construction of any building other
than in accordance with the Planning Scheme, any applicable laws and with the EDTL’s prior written consent.
You may wish to attach a map and highlight proposed sites for the sublease.
Describe the proposed premises; specify either an existing site or nominate an undeveloped area.
Proposed premises
Please provide information as appropriate / available
Lot number:
Street number and/or street name:
Land:
Survey plan number:
Do you plan to develop the site?
Yes No
If yes please provide details of type of development.
6. Proposed Business
What type of business are you proposing for the above site?
Please describe your proposed business:
Is the proposed business a new, extension or
continuation of your current business?
new business
extension / continuation of a current business
The EDTL is required to ensure that signage on sub-leased premises complies with all applicable laws and
advertising voluntary codes of conduct. Signage must not depict subject matter which is considered offensive
to the Township’s Aboriginal people.
What type of business are you proposing for the above site?
Please list relevant experience running a business:
Proposed Trading hours
Monday to Friday:
Weekends:
Trading Hours:
Please provide information regarding your timeframes for establishing the proposed business as applicable.
Please provide timeframes relative to the time from the date of signing the lease.
Approval for finance (if applicable):
Planning Approval:
Building Approval:
Commencement of building / fit out works:
Completion of building / fit out work:
Approval from the Land Council and/or certification:
Commencement of business operations:
7. Business Viability
7.1 All Applicants (all applicants to complete this section)
How will the business be financed? Please tick all that apply
Internal funding sources
External funding sources (eg funding from financial institutions)
Government funded
Please provide details of funding sources:
Development and building costs
Construction:
Building fit out:
Landscaping and road works:
Other capital costs:
Start up costs:
Connection (eg electricity and water):
Legal fees:
Other:
Total establishment costs:
8. Other Information
8.1 Third Parties
Do you propose to enter into a further relationship with a third party in relation to this sub-lease?
No Yes
If yes please provide the name of the third party
If yes please provide details regarding the nature of the agreement
8.2 Additional Information
Please attach the following documents
Any documentation that there is broad support for the proposed business activity from the Township’s residents
A signed and completed consent form to allow a credit check on the applicant business and all proposed personnel
Signed and completed consent form to allow police checks on the applicant business, any person concerned in
the management of the business and all proposed personnel, including a national police record check from a
Relevant Authority to determine whether a person has been convicted of a Sexual or a Crime against Children
Offence.
9. Additional Information
Executive Director of Township Leasing
Re: Letter of authority – Township commercial sublease application
1. I hereby confirm that the information contained in this application is, to the best of my knowledge, accurate and
complete.
2. I acknowledge that any sublease approval from EDTL is subject to mandatory acceptance of the terms of the
sublease document
3. I understand that the EDTL may need to obtain further information about this commercial sublease application
and that the EDTL is authorised to take all reasonable steps to obtain such information.
4. Consent is given by the applicant to any government body, organisation or business, which has information
relevant to this application to provide this information to the EDTL if requested by the EDTL.
Organisation Person who can legally bind the applicant
Print name
Person who can legally bind the applicant
Signature
Date
Organisation Person who can legally bind the applicant
Print name
Person who can legally bind the applicant
Signature
Date
If you are incorporated, affix your corporation’s
common seal here
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Commercial sublease application form (Department of the Prime Minister and Cabinet)

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Completed 11 February 2021

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