Renewal of Licence of a Morgue » City of Kalgoorlie-Boulder

Applicant Details

Applicant Name*

Contact Number*

Email Address*

Postal Address*

Suburb*

State*

Postcode*

Premises Details

Premises Name*

Premises Address

Street Address:*

City:*

State:*

Post Code:*

Country:*

Declaration*

I declare, as the Applicant, all the information supplied on this form is true and correct
I understand that the registration is for the period ending 30 June 2024
I understand that the City will action this form within 15 working days