This form is to record monthly usage for water users with and without telemetry to record amount taken under licensed and basic landholders rights (BLR) or another licence exemption.
If you have multiple meters, please submit a separate form for each meter.
Details of metered work
Recording and reporting
Terms and conditions
False or misleading information
Giving false or misleading information is a serious offence under Part 5A of the Crimes Act 1900. It is an offence under section 91J of the Water Management Act 2000 for a person to make a statement or supply information in or in connection with a metering record required to be kept that the person knows to be false or misleading in a material particular.
The personal information that is provided in this form will be managed by WaterNSW in accordance with its Privacy Procedure, or other such policy document as updated from time to time. The information provided in this form is being collected and used for purposes relating to the record confirmation of specified matter before water is taken described in this form to the Water Management Act 2000 (NSW). The information choose not to provide the requested information in this form, you may not be able to take water and you may be in breach of the Water Management Act 2000. You have the right to request access to, and correct details of your personal information held by WaterNSW.