Change of Name

  • Collection Notice
  • Confirm Your Identity
  • Name Change
  • Complete
This form is to be completed if you wish to change your name with Golden Plains Shire Council.   

To change your name, evidence will be required to be provided, this is either a copy of a Marriage Certificate/ Drivers Licence/ or other supporting documentation that may be applicable. This form is not to be used for change of ownership. 

 

Collection Notice

Personal information collected on this form will be used by Council’s Customer Experience team to update your contact details in Council’s systems. Council may disclose your information to other internal departments who also use your contact details to provide you with services in order to update your contact details and your information may be disclosed to external parties if required or authorised by law. If you do not provide us with all required information Council may not be able to update your contact details, which may have an impact on the services you receive.
Council will comply with its Privacy Policy, the Privacy and Data Protection Act 2014 and the Health Records Act 2001 in relation to the use, storage and disclosure of information.
If you have any queries regarding this collection notice, please contact the Privacy Officer on 03 5220 7111 or via [email protected]

Confirm Your Identity

Please include your title.

Name Change

One file only.
25 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
Back to top

Rate this page

Is this page useful?