Section 3 Supporting information for nomination
Any information entered in this section only may be copied and passed onto the owner of the property
you are nominating.
Why do you feel the property is an asset of community value? Please give as much information as
Why do you feel the property is an asset of community value?
Section 4 Boundary of property
What do you consider to be the boundary of the property? Please give as much detail/be descriptive
as possible (if possible, please include a plan).
What do you consider to be the boundary of the property?
Section 5 Attachment checklist
Copy of group constitution (if you are a constituted group)
Name and home addresses of 21 members registered to vote in nomination area (if group is not
Site boundary plan (if possible)
Section 6 Declaration
I can confirm that to the best of my knowledge the information contained in this nomination form is
complete and accurate.
Signed: Sign Dated: Date