* Denotes that the field is mandatory.
Fill in the appropriate fields below to initiate your request to update your contact details.
If information is incomplete or misleading, the update will not occur. We may ring or email you to clarify information given.
clearpixel.gif
Full name/company name
(include title, given names & surname)
*
Date of birth (optional)
Postal Address *
Suburb *
State *
Post Code *
Country
Previous postal address *
E-Mail Address *
Phone Number *
clearpixel.gif
Full name(s) of all people or companies affected
(title,given names & surname & date of birth)
clearpixel.gif
Requests for changes to a name must be accompanied by legal documentation that is evidence of the name change. The documentation needs to link the new name to the previous name.
One or more of these documents are required to support the change of name request: Change of Name Certificate, Marriage Certificate, Birth Certificate, Divorce Certificate (decree)
Previous name details
(include title, given names & surname)
Insert file
Note: File types accepted are: PDF; JPG image file; TIF image file and Word Document
Delete File
Insert file
Delete File
Comments