We have invited you to complete this survey so that you can
provide specific and more focused feedback to us on how the proposal might
affect you. Before completing this survey please take the time to
review the document titled "Additional Information", which has been prepared
for you and may address any concerns.
If however, after reviewing this document, you have further queries or
concerns regarding the proposal or would like to provide more specific feedback
regarding the proposal, we invite your comments by completing the survey.
Once the Community
Impact Statement has been finalised you will be notified of its lodgement
with the Casino, Liquor & Gaming Control Authority (the "Authority")
within 2 working days of its lodgement and you may care, at that stage, to
view the Application on the Authority's public notice board at www.olgr.nsw.gov.au. You will have further opportunity to comment on the proposal at that stage. Your
personal details, such as your name or contact details will not be disclosed to the Authority without your express consent.
To submit your feedback regarding the proposal please complete the survey and post or fax it to us using the details at the bottom of this form.
Name/Corporate Name:
Address:
Contact
Person:
Telephone
Number:
Facsimile
Number:
E-Mail:
Survey relates to premises at:
Check each box as appropriate
Have you read the document titled "Additional Information"?
Would you like a consultant to contact you to discuss the proposal with you?
Do you consent to your personal details being released to the Authority?
What is your preferred method for us to
contact you?
Phone
Fax
Email
Postal
How far away is the Proposed Premises from where you reside or work? Please distinguish whether the distance is to your place of work or place of residence.
Do you believe the Proposed Premises could adversely affect you, and if so, please specify in what way?
If you believe the Proposed Premises could adversely affect you, can you suggest any changes to the proposal that could lessen your concerns? For example, you might be aware of operational policies or procedures at a similar venue, which have been successfully implemented at those premises and which, if adopted by this proposal, would satisfy your concerns.
If on the other hand you believe the Proposed Premises could benefit you in some way please indicate in what way. For example, there may be increased employment opportunities for the community or improved shopping convenience and choice for you.
Do you have any other comments to make regarding the proposal?
Should you have any concerns with the proposal can we contact you to discuss those concerns further? If so, we will contact you by your preferred method indicated above. If you ticked by phone, please indicate when would be a convenient time for us to call you, such as at a particular time of the day or day of the week.
No
Yes, during the following times:
Thank you for taking the time to complete
this survey. Your comments will be reviewed and if necessary
we will contact you again to discuss the proposal.
Back Schwartz Vaughan
Level 5, 75-85 Elizabeth
Street, Sydney NSW 2000
Tel (02) 9223 3355 or Fax
(02) 9223 3142
(Tony Schwartz - tschwartz@bsv.com.au)