This form can be used to:
- advise the State Revenue Office of a change to your contact details, and/or
- nominate/authorise a representative to interact with the State Revenue Office on your behalf.
This form can be completed by a State Revenue Office customer or their agent or representative if they have previously been authorised to act on the customer's behalf.
Any changes to your records as a result of submitting this form will stay in effect until you advise us otherwise.
More information is available within the form.
This form has been merged with LTX Form 13, and the application process moved online. The old PDF version of this form is no longer accepted.
All properties which you own or jointly own will be included in any future land tax assessment notices issued. By authorising a representative to receive your correspondence, they will be privy to all the information contained within that correspondence.
This change of address or authority to act remains valid until you formally notify us of any changes.