Form 7
Variation Application Summary Cover Sheet
This form must be submitted for each variation to an approved submission with the revised Form 4
PART A: Submission Summary
NDRRA Event
Agency / Local Government
QldRA Submission Number
Council Submission Reference
Date
PART B: Project/Asset Summary
Name of Asset
Description of Asset
Type of Variation/Change
 Scope
 Treatment
Details of Variation/Changes
Reason for Variation/Changes
Date variation identified
PART C: Application
Details of supporting
documentation attached
Details of previous discussions
with QldRA
Has your RLO been notified?
Urgency for the variation
Council Contact Details
PART D: QRA Use Only
Advice Provide by RLO
In Principle advice provided by
Assessor
Formal Assessment Required
 Value
 Rates
Form 7
Variation Application Summary Cover Sheet
This form must be submitted for each variation to an approved submission with the revised Form 4
Name
Signature -
Applicant
Chief Executive
Officer /
Accountable
Officer
Date
Where do I get help?
Any queries regarding your submission should be directed to
submissions@qldra.org.au.
This information is being collected for the purposes of funding, management and reporting of reconstruction activities. This
information is collected pursuant to Part 2, Division 2 of the Queensland Reconstruction Authority Act 2011. The information
may be disclosed to the Commonwealth Government and Qld Government agencies, departments and statutory authorities
involved with reconstruction activities.