Location Information Sample
Please note: this form allows you to type into the text fields and then save the form to your computer.
For Google Chrome users, it is recommended you save the form first, open it in Adobe reader and
complete the form. The form can then be emailed to us.
Customer details
Company name:
ABN:
Contact name:
Position:
Address:
Email:
Phone number:
Mobile:
Web address:
Term of licence required
Term:
Please select
Location Information product (including any specific attributes or details required)
Format of the Location Information Product
Intended Use of the Location Information Product
Please email this form to geodata@landgate.wa.gov.au.
For enquiries, please contact Customer Service on (08) 9273 7373
landgate.wa.gov.au
Page 1 of 1