Power and Water Ring Fencing Guideline Information Sharing Protocol and Register

Ring-fencing

Information register application form

Legal entities requesting access to relevant ring-fenced information must complete the following form. By signing and submitting this Information Register Application form, the requesting entity consents to its detail and the details of its information request being made publicly available on our website.

Requesting entity's details

Full legal name *

ABN/ACN (if applicable)

Address

Email * Ring -fencing information will be sent to this email address

Contact details

Given name *

Family name *

Position *

Phone number *

Email *

Alternate contact (if applicable)

Given name

Family name

Position

Phone number

Description of Requesting Entity's business activities (if applicable)

Information request

Description of information requested *

Proposed use of the information * Describe the kind of information requested in sufficient detail to enable other legal entities to make an informed decision about whether to also request that kind of information.

Acknowledgement and Authority

I / Requesting Entity agrees *

To the terms on which we will share the ring-fenced information with it as detailed in the Information Sharing Protocol.

I / Requesting Entity accept that *

We are responsible for all costs it incurs in relation to registering on the Information Register and accessing the ring-fenced information

I / Requesting Entity warrant that *

You have the authority to sign this agreement and bind the Requesting Entity.

I / Requesting Entity give consent to Power and Water Corporation *

To use and disclose my personal information in accordance with the Power and Water Privacy Policy, available at www.powerwater.com.au/privacy

Ring-fencing

Information register application form

Ring-fencing information register application form