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Online Form - Change your details

Please attach certified copies of documentation confirming these changes ie. Marriage Certificate

Supporting documents*

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First name*

Surname*

Residential Address

Street Address:*

City:*

State:*

Post Code:*

Country:*

Postal address (if different)

Email*

Telephone Number

Previous Name (in full)

Previous Residential Address

Previous Postal Address

Previous Email

Previous Telephone Number*

I understand that in completing and submitting this form, any previous details held by the Shire of Toodyay will be replaced with the new details on this form. I understand that the Shire may contact me for any further verification of this detail.

Date

Preferred contact method*

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Online Form - Change your details

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