EOD1

EOD1 - Environmental Offsets Delivery Form 1 –Notice of Election and Advanced Offset Details

(This form is an approved form under Section 92 of the Environmental Offsets Act 2014)

For all environmental offset applications you must:

  • Complete this form (Environmental Offsets Delivery Form 1 –Notice of Election and Advanced Offset Details); and
  • Provide any mandatory supporting information relevant to your application as directed.

This form is necessary for ALLenvironmental offsets deliveryapplications, including advanced offset applications.

PART A –OFFSETTYPE DETAILS
Is this Application for:
  • A Standard Offset ☐> Continue to PartB
  • A Staged Offset ☐ > Continue to Part B
  • An Advanced Offset ☐> Continue to Part C

PART B – PARENT APPLICATION DETAILS (e.g. Development Application or Environmental Authority)
Administering Agency Reference number:
Application Category:
Project Name Offset Stage Number (where applicable): of
Supporting Information Attached (for Staged Offsets):
  • Your properly madeEnvironmental OffsetsDelivery Form 6 – Staged Offset Details ☐
> Continue to Part D
PART C –APPLICANT DETAILS (Advanced Offsets Only)
Name/s (individual or company name in full) /
For companies, contact name /

Postal address /
Suburb
State / ACTNSWNTQLDSATASVICWA / Postcode
Country
Other
ACN: /

Contact phone number:

Mobile number (non-mandatory requirement)
Fax number (non-mandatory requirement) /

Email (non-mandatory requirement)
Supporting Information Attached:
  • Environmental Offsets Delivery Form 3– Offset Area Details ☐
  • Environmental Offsets Delivery Form 5– Habitat Quality Details (not required for SEQ koala habitat tree counts)☐
> Continue to Part E
PART D – NOTICE OF ELECTION
Notice
Environmental Offsets Act 2014
Notice of Election
This notice is issued by the applicant to agency responsible for the administration of environmental offsets in Queensland pursuant to section 18 of the Environmental Offsets Act 2014 to provide notice of election.

Administrative details:Administering Agency Reference Number:
Project Name:<Auto-populated from Part B>
Offset Stage Number (where applicable):<Auto-
Notice of Election:
This form provides official notification that an offset condition for a prescribed activity pertaining to the abovementioned case reference will be met by the authority holder by way of the following offset delivery mechanism:
i)A proponent driven offset
Supporting information attached:
  • Environmental Offsets Delivery Form 2- Offset Delivery Plan ☐
  • Environmental Offsets Delivery Form 3– Offset Area Details ☐
  • Environmental Offsets Delivery Form 5– Habitat Quality Details(not required for SEQ koala habitat tree counts)☐
  • Environmental Offsets Delivery Form 6 – Staged OffsetDetails ☐
ii)A financial settlement
Supporting information attached:
  • Environmental Offsets Deliver Form 4 – Financial Settlement Details ☐
iii)A combination of both
To work out your breakdown of land based and financial offsets please use the Combined Offsets Delivery Calculator.
Supporting information attached:
  • Environmental Offsets Delivery Form 2 - Offset Delivery Plan ☐
  • Environmental Offsets Delivery Form 3– Offset Area Details ☐
  • Environmental Offsets Delivery Form 4 – Financial Calculator Results ☐
  • Environmental Offsets Delivery Form 5 – Habitat Quality Details(not required for SEQ koala habitat tree counts) ☐
  • Environmental Offsets Delivery Form 6 – Staged OffsetDetails ☐
> Continue to Part E
PART E – DECLARATION
Note: If you have not told the truth in this application you may be liable for prosecution under the relevant Acts or Regulations.
  • I do solemnly and sincerely declare that the information provided is true and correct to the best of my knowledge and I make this solemn declaration conscientiously believing the same to be true.
  • I understand that all information supplied on or with this application form may be disclosed publicly in accordance with the Right to Information Act 2009 and the Evidence Act 1977.
Full Name Contact Phone or Email
Date Click here to enter a date.
PART F – HOW TO SUBMIT A NOTICE OF ELECTION
i)Submitting and notice of election application
To submit a notice of election application for assessment purposes, ensure all relevant parts of this form have been filled in correctly and forward it together with any mandatory attachments to the relevant Administering Agency responsible for administering the offset condition.
ii)Pre-lodgement meetings
To request a pre-lodgement meeting in order to discuss or clarify the details your notice of election, please fill in and submit the following pre lodgement form as requested. Application for a pre-design/pre-lodgement meeting - EM1125 (Word, 188K)‡
iii)Further information
For further information about an offsets in general please email to discuss a current offset application please phone 13QGOV (13 74 68)
PART G - OFFICE USE ONLY
Administering Agency Choose an item.
Technical Assessment Agency Details:
Agency Name Region Service Centre Officer
Choose an item. Choose an item.Choose an item.Click here to enter text.
Received Date Recommendation Due Date Recommendation Made Date
date. date. date.
Details entered in offsets Register ☐
Notes