Smart Approved WaterMark online application form - products

1. Explanatory Notes

2. Applicant Details

3. Company Details

The name of this organisation.
Address for correspondence
Phone number.
Fax number.
Email address.
To be used for product listing if approved

4. Product Details

The name of this product.
Model number.
Recommended retail price for this product.
Describe how this product saves water.
Under what circumstances might the use of this product not result in water savings?
How much water does this product use? Units could be litres/min, litres/hour, or litres/year.
Is the water use information independently verified?
If water use information is verified, please attach details of the independent verification. i.e. A copy of the results/report.
How much water does this product save? (Include common usage ofwater savings by using this product).
Is the water savings information independently verifield?
If Yes, please attach details of the independent verification ie copy of the test results/report
If possible, please supply a sample. If a sample is NOT practical, please attach a short video or photographs of the product.
What water saving information is provided to customers to ensure current usage and application?
Extra information relating to correct usage and application.
Does this product comply with all the appropriate national and state regulatory, health, plumbing and standards requirements?
If "No" to the above, please provide details.
Does this product have any possible negative health and environmental risks?
If "Yes" to the above, please provide details and any consumer safety information provided with the product.
Does this product come with a warranty/guarantee?
If "Yes" to the above, please attach a copy of the warranty/guarantee.

Referee 1

Referee 2

Provide the details of an employee who can clarify any technical details and/or answer any other questions regarding this application.

Additional attachment file 1.
Additional attachment file 2.

5. Declaration

I, as the authorised representative of acknowledge that: