Plumbing Mutual Recognition Application

Size: px
Start display at page:

Download "Plumbing Mutual Recognition Application"

Transcription

1 Plumbing Mutual Recognition Application Address: GPO Box 536, Melbourne VIC 3001 Phone: Fax: (03) Mutual recognition is based on an agreement between the states, territories and the Commonwealth working together through the Council of Australian Governments (COAG), to grant equivalent licensing to plumbers across regulators. A website has been established to enable users to look up registration / licence entitlement in another state or territory, based on the currently-held licence. That website is To gain your equivalent registration / licence in Victoria, apply to the Victorian Building Authority (VBA) using this Mutual Recognition form. If you do not have an equivalent registration / licence you can still apply with the VBA using the Non- Apprentice Application form. Introduction Key components of Victoria s plumbing regulatory system are the licensing and registration of practitioners, compulsory insurance, the self-certification of work and on-site regulation of plumbing work. All significant plumbing work must be carried out by a licensed or registered practitioner. All licensed and registered persons have demonstrated an appropriate level of competence in their field. Consumer protection is ensured with each licensed person carrying a mandatory minimum level of insurance. Each self certifies that their work complies with relevant regulations, standards and codes through the VBA s plumbing compliance certificate system, and the integrity of the system and work standards are protected through random VBA plumbing inspections and audits supported by appropriate sanctions where necessary. In turn, licensed and registered practitioners operate in a respected and transparent industry where training and skills are prerequisite entry requirements. Becoming Licensed or Registered If you carry out plumbing work in Victoria, you must be registered or licensed with the Victorian Building Authority. Section 221D, under Part 12A of the Building Act 1993, states: "A person must not carry out any plumbing work of a particular class or type unless he or she is licensed or registered by the Authority to carry out work of that class or type." The penalty for carrying out plumbing work, while not being registered or licensed is up to $73,805. Licensing Once a person is registered in a class of plumbing with the VBA, that person may elect to undertake the VBA s theory (licence) assessment to become eligible for a licence in that class. Licensed people in a particular class of plumbing may undertake all relevant work, certify the work themselves, and supervise / certify the work of other licensed or registered persons in that class, provided they have relevant insurance (see Information Sheet - Insurance). Registration A person who is registered may undertake relevant work for the classes that they are accredited in, but must do so under the supervision of a licensed person. The work of a registered person must be certified by a licensed person. Privacy: The Victorian Building Authority (VBA) recognises the importance of protecting your privacy. The VBA is committed to, and is obliged to adhere to the requirements of the Information Privacy Act A copy of the VBA's Privacy Policy is available on the VBA's website at or from any office of the VBA. Further information regarding the Privacy Act 2000 is available at the website of the Victorian Privacy Commissioner at

2 Information Sheet Plumbing - Insurance Address: GPO Box 536, Melbourne VIC 3001 Phone: Fax: (03) Insurance for Licensed Practitioners A key component of Victoria s plumbing regulatory system is that all licensed practitioners must provide evidence to the Victorian Building Authority (VBA) that they hold the relevant insurance before the VBA may issue or renew a plumbing licence. Why do licensed practitioners need insurance? Sections 221M and 221Qof the Building Act 1993 requires that the VBA only issue a licence to a person who is covered by the "required insurance." As self-certifiers of their work, licensed practitioners are responsible for their work. It is essential for both practitioners and the public that they carry adequate insurance protection. Just as the public need to be protected, the assets of a licensed practitioner also need to be protected. What is the required insurance? The required insurance is a minimum level of insurance which has been prescribed by the Victorian Government in 2 separate Ministerial Orders; licensed persons may elect to take a greater level of insurance than that prescribed: Ministerial Order Licensed Plumbers General Insurance Order signed by the Minister on 20th June 2002 prescribes the minimum insurance required by all licensed persons (except those licensed in Type B Gasfitting). Ministerial Order Licensed Plumbers (Type B Gasfitting work) Insurance Order signed by the Minister on 20th June 2002 prescribes the minimum insurance required by all persons who are licensed in Type B Gasfitting. Where a person is seeking to be licensed in Type B Gasfitting and any other class of plumbing, that person must have insurance which complies with both Ministerial Orders. A copy of the Ministerial Order is available from the Information Victoria Bookshop at 356 Collins Street Melbourne ( ). It may also be accessed through the Plumbing Industry Commission s website at Can a plumbing licence be issued before the insurance is issued? No. The Act requires that the VBA ensures that the applicant has complying insurance prior to the licence being issued. What does the VBA require as evidence of insurance? Prior to the issue of a plumbing licence, VBA operators are instructed that they must receive a Certificate of Currency (not offers of insurance, or other insurance documents) which: Includes the name of the person who is to be licensed - as the insured (i.e. not just a company name). States the period of insurance (the licence can only be issued for the insured period), the name of insurer and policy number. Includes the notation - this insurance complies with all the requirements of the Ministerial Order Licensed Plumbers General Insurance Order dated 20th June OR - in respect of Type B Gasfitting, - this insurance complies with all the requirements of the Ministerial Order Licensed Plumbers (Type B Gasfitting work) Insurance Order dated 20th June 2002

3 Insurance for Licensed Practitioners The following list of insurers and/or insurance brokers have either (a) advised the VBA that they provide insurance which complies with the requirements of the insurance ministerial orders for licensed persons, OR (b) have been observed by the VBA to provide a complying insurance policy. All persons considering an application for a licence should familiarise themselves with their own insurance requirements, and those of the Ministerial Order. The VBA advises all licensed practitioners to seek their own independent insurance advice. Neither the VBA, nor its employees are in a position to provide insurance advice. The list is provided as a service to persons who intend to seek the issue of a licence with the VBA. It does not constitute an endorsement by the VBA. Other organisations may also provide a complying insurance product. Arrowsmith & Petruccelli Insurance Brokers Address 679 Boronia Rd, Wantirna South 3152 Phone Atia Insurance Brokers Address Level 7/406 Collins St, Melbourne 3000 Phone Atlantic Insurance Brokers Address 102/ Whitehorse Rd, Surrey Hills 3127 Phone Fraser & Associates Insurance Brokers PO Box 574, Croydon 3136 Phone GIO Phone IPSM Insurance Agents PO Box 292, Werribee 3030 Phone James Wiltshire Pty Ltd Address 226 Charman Rd, Cheltenham 3192 PO Box 2582 Cheltenham VIC 3192 Phone Fax Johansen Insurance Brokers Wangaratta Address 47 Ovens St, Wangaratta 3677 Phone Johansen Insurance Brokers Bendigo Address 41 Hopetoun St, Bendigo 3550 Phone Master Plumbers Insurance Brokers Phone McCormick Harris Insurance Brokers Address 422 Hargreaves Street, Bendigo 3550 Phone McNair-Hurle La Trobe Insurance Brokers Address 205 Princess Dr, Morwell 3840 Phone PBS Insurance Brokers Pty Ltd Address Suite 1, 43 Railway Rd, Blackburn 3130 Phone QBE Australia Ltd. Phone or Roderick Insurance Brokers Address 116 Yarra St, Geelong Phone Suncorp Phone Vero Insurance Phone Victorian Risk Management Insurance Services Address 22/1253 Nepean Hwy, Cheltenham VIC 3192 Wesfarmers Federation Insurance Address 369 High St, Kew 3101 Phone Willis Australia Ltd Address Level 5/570 Bourke St, Melbourne 3000 Phone Windsor Management Insurance Brokers Address King St, West Melbourne 3003 Phone Your Insurance Group PO Box 2068 Kew 3101 Phone Zurich Phone

4 Plumbing Mutual Recognition Application Form Building Act 1993 Address: GPO Box 536, Melbourne VIC 3001 Phone: Fax: (03) I hereby apply for accreditation with the Victorian Building Authority (VBA) using my accreditation from a regulator in another state or territory of Australia or from New Zealand - as the basis of my registration or licence eligibility in Victoria. 1. Your Details First Name: Middle Name(s): Surname:_ Postal Address: Suburb: _ Post Code: State: Residential Address: Suburb: _ Post Code: State: Home Phone: Mobile Phone: Business Phone: Facsimile: _ Date of Birth: / _/ _ 2. Accreditations Please give details below of your interstate / NZ plumbing accreditation Accreditation Issuing Authority: Issued Number: _ Country of Issue: Issue Date: /_ /_ Expiry Date: / /_ Categories: _ I have attached a certified photocopy of the front and back of my interstate / NZ plumbing card

5 3. Declaration Under section 221T(2) of the Building Act 1993, you are required to state whether you have: 1. Been Convicted of any offences involving fraud, dishonesty, drug trafficking or violence that was punishable by imprisonment for 6 months or more. Yes No 2. Been convicted of an offence under any law regulating plumbing work or specialised plumbing work. Yes No 3. Had your authorisation to carry out plumbing work or specialised work suspended or cancelled for any reason other than your failure to renew that authorisation. Yes No 4. Become an insolvent under administration. 5. Been convicted of an offence against section 12, 16, 17, 18, 20 or 22 of the Fair Trading Act 1985; or section 10, 11, 12, 17, 19 or 21 of the Fair Trading Act 1999; or section 53, 55, 55A, 56, 58 or 60 of the Trade Practices Act 1974 of the Commonwealth; or section 29, 33, 34, 35, 36, 50, 151, 157, 158 or 168 of the Australian Consumer Law (Victoria) or Schedule 2 to the Competition and Consumer Act 2010 of the Commonwealth. Yes Yes No No - If you have answered Yes to one or more of the above questions, please attach the details to this form. I declare that the information contained in this form, or attached by me to this form, is complete and true to the best of my knowledge. I give consent for enquiries to be made into any of the information I have given on this form. I hereby authorise the Registrar - VBA to apply for, and to receive my National Police Certificate as required by section 221(2)(ba) of the Building Act Signature: Date: _ / _ / Note: Section 221ZZZG(1)(a) of the Building Act 1993 provides that obtaining a registration or licence by way of fraud, misrepresentation or concealment of the facts in the information provided to the VBA, is proper cause for disciplinary action. Section 221V of the Building Act 1993 provides that it is an offence to give false information in your application.

6 Tax Invoice Registration and Licence Fees ABN: Registration & Licence Fees Application Fee (non-refundable) $52.22 Registration Fee (3 year period) $ Licence Fee (1 year period) $ Month Licence Fee $ Month Licence Fee $ Month Licence Fee $71.94 Payment Details Please pay the appropriate fee(s) as outlined above, if you are unsure of the required fees please call the Victorian Building Authority. Payment Due: $ $ = $ Payment by Cheque or Money Order Cheques should be made payable to Victorian Building Authority Plumbing Account I have attached a cheque or money order to this Tax Invoice Payment by Credit Card Credit Card Number: Cardholders Name: Type of Card: Visa MasterCard Expiry Date: / Signature: Date: / /

7 Photo Identification Form Address: GPO Box 536, Melbourne VIC 3001 Phone: Fax: (03) All Victorian Building Authority (VBA) plumbing accreditation cards include a photograph of the holder. The Photo ID card assists all accredited persons to readily establish their identity, as well as their level of accreditation with the VBA. To produce your photo ID card, we need you to provide two photographs, fill in the details below and return it to any of the VBA s offices. If you have provided photographs in the last 5 years, there is no need to provide further photographs now. Your Details First name: Surname: Date of Birth: VBA Reference No: Passport Photo Requirements Photos are no more than 6 months old. Photos are high quality. Digital photos are printed on photo paper. Photos are at least 45mm high by 35mm wide. You are looking directly at the camera. Photos do not have any border. I have supplied 2 Passport Photos. If the above requirements are not met, your photos will be returned to you and you will need to provide further photographs that meet the above requirements. Attach Your Photos X Position centre of photo here. Please write your name on the back and affix with double-sided tape. X Position centre of photo here. Please write your name on the back and affix with double-sided tape.

8

Agents financial administration Form 4

Agents financial administration Form 4 Agents financial administration Form 4 Collection agent application for authority to open a trust account Agents Financial Administration Act 2014 Debt Collectors (Field Agents and Collection Agents) Act

More information

Form 11 Application for electrical work licence/permit (other than apprentice)

Form 11 Application for electrical work licence/permit (other than apprentice) Electrical Safety Office Form 11 Application for electrical work licence/permit (other than apprentice) V15.06-2014 Electrical Safety Act 2002 If you are applying for an additional electrical work training

More information

Fair Trading will aim to make a decision on your application within 6 weeks after receiving all relevant information from you and other agencies.

Fair Trading will aim to make a decision on your application within 6 weeks after receiving all relevant information from you and other agencies. Application No. OFFICE USE ONLY Form PL-21 ABN 81 913 830 179 Property, Stock and Business Agents Act 2002 Application for a CERTIFICATE OF REGISTRATION FEE: $129.00 - applicable from 1 July 2015 to 30

More information

Individual Construction Occupations (Licensing) Act 2004, s128 and s17

Individual Construction Occupations (Licensing) Act 2004, s128 and s17 Application to renew/issue an expired licence Construction Occupation licence Individual Construction Occupations (Licensing) Act 2004, s128 and s17 This form is to be used for individuals to: renew a

More information

Application for Construction Occupation Licence Individual Plumber Construction Occupations (Licensing) Act 2004, s128 and s17

Application for Construction Occupation Licence Individual Plumber Construction Occupations (Licensing) Act 2004, s128 and s17 Application for Construction Occupation Licence Individual Plumber Construction Occupations (Licensing) Act 2004, s128 and s17 This approved form is to be used for individuals applying under the Construction

More information

Form 18 Application for a Queensland electrical contractor licence

Form 18 Application for a Queensland electrical contractor licence Electrical Safety Office Form 18 Application for a Queensland electrical contractor licence V17.06-2014 Electrical Safety Act 2002 INSTRUCTIONS: Read the guidelines when completing this application form.

More information

Renewal of registration Building surveying contractor (individual) Form 63

Renewal of registration Building surveying contractor (individual) Form 63 Government of Western Australia Department of Commerce Renewal of registration Building surveying contractor (individual) Form 63 Use of this form This form is to be used by building surveyors who are

More information

Application for a real estate salesperson registration certificate

Application for a real estate salesperson registration certificate New registration application Form 3 1 Notes Application for a real estate salesperson registration certificate Property Occupations Act 2014 This form is effective from 1 December 2014 ABN: 13 846 673

More information

APPLICATION FOR REGISTRATION AS A BUILDING PRACTITIONER CERTIFYING ENGINEER - INDIVIDUAL

APPLICATION FOR REGISTRATION AS A BUILDING PRACTITIONER CERTIFYING ENGINEER - INDIVIDUAL NORTHERN TERRITORY BUILDING PRACTITIONERS BOARD APPLICATION FOR REGISTRATION AS A BUILDING PRACTITIONER CERTIFYING ENGINEER - INDIVIDUAL SECTION 1 PERSONAL DETAILS FAMILY NAME (Surname) GIVEN NAME (First

More information

LAST NAME GIVEN NAME(S) DATE CEASED / / LAST NAME GIVEN NAME(S) DATE CEASED / /

LAST NAME GIVEN NAME(S) DATE CEASED / / LAST NAME GIVEN NAME(S) DATE CEASED / / Application by an INDIVIDUAL FOR A NSW SECURITY LICENCE under the Mutual Recognition Act 1992 and/or Trans-Tasman Mutual Recognition Act 1997 OFFICE USE ONLY Application No: - Receipt No: - Trim No: To

More information

Application for an Electrical Contractor s Licence

Application for an Electrical Contractor s Licence Application for an Electrical Contractor s Licence 303 Sevenoaks Street (entrance Grose Ave) Cannington WA 6107 Postal Address: Locked Bag 14 Cloisters Square WA 6850 Telephone: (08) 6251 2000 Email enquires

More information

Mutual Recognition. Who can apply? Build better.

Mutual Recognition. Who can apply? Build better. Build better. Mutual Recognition Mutual Recognition is a process whereby an individual who holds a licence in one state, territory or New Zealand is entitled to be licensed in another state, territory

More information

Form 20 Application for additional/change of qualified person for a contractor licence

Form 20 Application for additional/change of qualified person for a contractor licence Department of Justice and Attorney-General Electrical Safety Office Form 20 Application for additional/change of qualified person for a contractor licence V12.06-2014 Electrical Safety Act 2002 INSTRUCTIONS:

More information

Application to register a change of name (adult 18+ years)

Application to register a change of name (adult 18+ years) Application to register a change of name (adult 18+ years) July 2014 Recognising the significance of life events Important information about your change of name application If you require access to a translation

More information

Information for temporary residents departing Australia

Information for temporary residents departing Australia Information for temporary residents departing Australia MLC Superannuation What is a Departing Australia Superannuation Payment? The Departing Australia Superannuation Payment (DASP) is the payment of

More information

Application for superannuation benefits temporary residents departing Australia permanently

Application for superannuation benefits temporary residents departing Australia permanently GPO Box 89 Melbourne Vic 3001 VicSuper Member Centre 1300 366 216 vicsuper.com.au Application for superannuation benefits temporary residents departing Australia permanently * Indicates that providing

More information

ARCHITECTS BOARD OF WESTERN AUSTRALIA

ARCHITECTS BOARD OF WESTERN AUSTRALIA ARCHITECTS BOARD OF WESTERN AUSTRALIA Application for Registration in Western Australia under Mutual Recognition Form 02 3 August 2015 Use of this Form This form is to be used by people wishing to apply

More information

Bookmaker Licence Application FEE: $310

Bookmaker Licence Application FEE: $310 Bookmaker Licence Application FEE: $310 Please note The Racing Act 2002 (which can be accessed via the internet at www.legislation.qld.gov.au regulates the manner in which licensed racing bookmakers may

More information

Application for Registration as an Agent s Representative

Application for Registration as an Agent s Representative Application for Registration as an Agent s Representative Agents Licensing Act Please print in block letters. If there is insufficient space, attach extra sheets. All questions must be answered and full

More information

Application for registration Building contractor (company)

Application for registration Building contractor (company) Government of Western Australia Department of Commerce Application for registration Building contractor (company) Refer to the application guidelines for assistance in completing this application form.

More information

Victoria - Builders Home Warranty Insurance Job Specific Application Form

Victoria - Builders Home Warranty Insurance Job Specific Application Form \ Victoria - Builders Home Warranty Insurance Job Specific Application Form Commercial & General Insurance Brokers (Aust) Pty Ltd Suite 4, 1016 Doncaster Road Doncaster East Victoria 3109 Phone: 1300 764

More information

CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION

CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION PLEASE READ THESE INSTRUCTIONS CAREFULLY This is an interactive

More information

Licence Application Form COMPANY

Licence Application Form COMPANY Licence Application Form COMPANY Completing this form Use BLACK pen only Print clearly in BLOCK LETTERS DO T use correction fluid any amendments should be crossed out and initialled 1. COMPANY DETAILS

More information

Three year term. (One licence category includes non-refundable application fee of $144.60 ) $1242.60 $2329.60 $144.60

Three year term. (One licence category includes non-refundable application fee of $144.60 ) $1242.60 $2329.60 $144.60 New licence application Form 1 1 Notes Application for an individual s licence Real estate agent, property auctioneer, resident letting agent, motor dealer, chattel auctioneer Property Occupations Act

More information

Restricted (Corporate Lawyer)

Restricted (Corporate Lawyer) 2015-2016 Application for a Restricted (Corporate Lawyer) Local Practising Certificate and Membership te: Legal practitioner employed by an entity (excluding a government agency or law practice) and limited

More information

Advantages: How it works:

Advantages: How it works: Suncorp Wealth Cash Management Account Application Form Details Suncorp Wealth Cash Management Account offers competitive interest with no ongoing fees and charges. To conveniently settle your share purchases

More information

The Airlie Share Fund Application Form for Individual / Joint Investor / Sole Trader / Individual Trustee

The Airlie Share Fund Application Form for Individual / Joint Investor / Sole Trader / Individual Trustee The Airlie Share Fund Application Form for Individual / Joint Investor / Sole Trader / Individual Trustee This Application Form forms part of the Information Memorandum for The Airlie Share Fund (Fund).

More information

1. Applicant details. 2. Corporate applicant. Individual / Partner 1 Given names (do not abbreviate) Surname (include maiden name if married)

1. Applicant details. 2. Corporate applicant. Individual / Partner 1 Given names (do not abbreviate) Surname (include maiden name if married) Application for a Licence to Sell Poisons for Purposes other than Human Therapeutic Use (please refer to the Fact Sheet at the back of this form when completing this application) Are you: a sole trader

More information

Student Enrolment Form Life Insurance Adviser Course RG146

Student Enrolment Form Life Insurance Adviser Course RG146 Student Enrolment Form Life Insurance Adviser Course RG146 Applications may be submitted by ANY of the following methods: Email: enrol@monarch.edu.au (Preferred option) Post: Monarch Institute Administration:

More information

Application to register a change of name (adult 18 years or over)

Application to register a change of name (adult 18 years or over) Government of Western Australia Department of the Attorney General Registry of Births, Deaths & Marriages BDM400 Application to register a change of name (adult 18 years or over) Eligibility You must be

More information

PA01 July 2015 - Page 1 of 12

PA01 July 2015 - Page 1 of 12 Provider approval PR- (Office Use Only) Before you begin You must read the following information before completing and submitting this form. Use this form to... Apply for provider approval. You must have

More information

Professional indemnity insurance

Professional indemnity insurance Professional indemnity insurance 2014 mini policy for CPA Australia members What is CPA Australia s mini policy? Fenton Green & Co. has arranged a professional indemnity insurance (Pll) mini policy (mini

More information

Registration Building surveying contractor (company) Form 38

Registration Building surveying contractor (company) Form 38 Government of Western Australia Department of Commerce Registration Building surveying contractor (company) Form 38 Use of this form This form is to be used by unincorporated bodies, body corporate and

More information

Application for Department of Agriculture Approved Auditor

Application for Department of Agriculture Approved Auditor Application for Department of Agriculture Approved Auditor Export Control (Eggs and Egg Products) Orders 2005 Export Control (Fish and Fish Products) Orders 2005 Export Control (Meat and Meat Products)

More information

Fit and proper person form

Fit and proper person form Fit and proper person form Last updated: 9 March 2015 About this form To hold any maritime document(s), you are required to be a fit and proper person. This applies at all times while the documents are

More information

Professional Indemnity Insurance Application Form for Eligible Midwives

Professional Indemnity Insurance Application Form for Eligible Midwives Professional Indemnity Insurance Application Form for Eligible Midwives This Form will be used by MIGA to consider your application for Professional Indemnity Insurance with MIGA and for your automatic

More information

Registration as a Physiotherapist within the Special Purpose Scope of Practice: Postgraduate Physiotherapy Student

Registration as a Physiotherapist within the Special Purpose Scope of Practice: Postgraduate Physiotherapy Student APPLICATION FORM Registration as a Physiotherapist within the Special Purpose Scope of Practice: Postgraduate Physiotherapy Student Please complete this Application Form with reference to the Application

More information

Application for Security Officer and/or Crowd Controller Licence

Application for Security Officer and/or Crowd Controller Licence Application for Security Officer and/or Crowd Controller Licence Private Security Act Please print in block letters. All questions must be answered and full particulars provided. If there is insufficient

More information

APPLICATION FOR. License Fee Only. Non- NZTA

APPLICATION FOR. License Fee Only. Non- NZTA C4:08-15 NEW ZEALAND THOROUGHBRED RACING INC PO Box 38386, WMC Telephone: (04) 576 6240 Facsimile: (04) 568 8866 Web: www.nzracing.co.nz Email: licensing@nzracing.co.nz APPLICATION FOR Non- NZTA License

More information

Application for a Practising Certificate & Membership of The Law Society of New South Wales

Application for a Practising Certificate & Membership of The Law Society of New South Wales Legal Profession Act 2004 ACN 000 000 699 ABN 98 696 304 966 Application for a Practising Certificate & Membership of The Law Society of New South Wales To be completed by an Australian lawyer who does

More information

Merchant Facility. Application - Australia. Important Notes

Merchant Facility. Application - Australia. Important Notes Merchant Facility Application - Australia Important Notes 1. If this application is incomplete, or we have not received all of the required supporting documents, we cannot begin to process your application.

More information

APPLICATION FOR A HIGH RISK WORK LICENCE Work Health and Safety Act 2011

APPLICATION FOR A HIGH RISK WORK LICENCE Work Health and Safety Act 2011 APPLICATION FOR A HIGH RISK WORK LICENCE Work Health and Safety Act 2011 PURPOSE This form is to be used to apply for a high risk work licence under the Work Health and Safety Act 2011 (the Act). You can

More information

Application for Accreditation by Testing

Application for Accreditation by Testing Application for Accreditation by Testing OFFICE USE ONLY AUS NZ OS Please use blue or black ball point pen to complete this form. Please print in BLOCK LETTERS. NAATI Number: (if known) Part 1 Please provide

More information

Payment of unclaimed superannuation money

Payment of unclaimed superannuation money Instructions and form for super fund members Payment of unclaimed superannuation money How to complete your Application for payment of unclaimed superannuation money individual. For information about unclaimed

More information

APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS

APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS REGISTRATION, EMPLOYMENT OR UNIVERSITY ENTRY This form is for the assessment of psychology qualifications for registration, employment or entry

More information

Please only use this form when you wish to open a Suncorp Share Trade Account: in your name, or in joint names

Please only use this form when you wish to open a Suncorp Share Trade Account: in your name, or in joint names Stockbroking INDIVIDUAL/JOINT ACCOUNT application form Please only use this form when you wish to open a Suncorp Share Trade Account: in your name, or in joint names In order to process your application

More information

APPLICATION FOR A LICENCE Security & Related Activities (Control) Act 1996

APPLICATION FOR A LICENCE Security & Related Activities (Control) Act 1996 WESTERN AUSTRALIA POLICE APPLICATION FOR A LICENCE Security & Related Activities (Control) Act 1996 Instructions to applicants follow all of these steps to complete your application You must carefully

More information

REQUEST FOR WITHDRAWAL

REQUEST FOR WITHDRAWAL REQUEST FOR WITHDRAWAL If you need help For assistance call NGS Super Customer Service Team on 1300 133 177. Step 1. Complete your personal details Please print in black or blue pen, in uppercase, one

More information

Application for a departing Australia superannuation payment

Application for a departing Australia superannuation payment Instructions and form for temporary residents Application for a departing Australia superannuation payment How to complete your Application for a departing Australia superannuation (super) payment. WHO

More information

Professional Indemnity Insurance and optional Public & Products Liability

Professional Indemnity Insurance and optional Public & Products Liability Advantedge Members (Incorporating PLAN, FAST and CHOICE Members) Professional Indemnity Insurance and optional Public & Products Liability Proposal form 2014-2015 Please return completed proposal form

More information

A licensed ground distribution contractor may only authorise the carrying out of ground distribution of herbicides from ground equipment.

A licensed ground distribution contractor may only authorise the carrying out of ground distribution of herbicides from ground equipment. Form 9 Application for an Aerial or Ground Distribution Contractor Licence Background Information This form is completed when making application to the Agricultural Chemicals Distribution Control Board

More information

Instruction Pages Individual Operator Private Security Licence Application

Instruction Pages Individual Operator Private Security Licence Application Please remove Instruction Pages before submitting your application VP Form 1080 Instruction Pages Individual Operator Private Security Licence Application Security Guard, Crowd Controller, Investigator,

More information

Consumer and Business Services

Consumer and Business Services Consumer and Business Services Born in South Australia Register a Change of Name Application (child under 18) To change a child s name you must complete this form, pay the appropriate fee and provide documentation

More information

Application for a Security Firm licence

Application for a Security Firm licence Private Security Act Please print in block letters 1. Type of application How will the business be structured? Natural person (Sections 2, 3, 9, 13, 14 and 15 of application) Natural persons in partnership

More information

2016 Application & Registration Form ARF

2016 Application & Registration Form ARF ABN 82 055 042 852 Training Assessment 2016 Application & Registration Form ARF This form applies to medical practitioners who will be training in Australia and New Zealand. You can apply or register at

More information

VIC - Builders Home Warranty Insurance Multi Unit Development Application

VIC - Builders Home Warranty Insurance Multi Unit Development Application Commercial & General Insurance Brokers (Aust) Pty Ltd Suite 4, 1016 Doncaster Road Doncaster East Victoria 3109 Phone: 1300 764 244 Fax: 03 8841 4299 Email: home.warranty@cgib.com.au Web: www.cgib.com.au

More information

APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS

APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS MIGRATION This form is for the assessment of psychology qualifications for the purposes of migration to Australia under the General Skilled Migration

More information

MEDICAL PRACTITIONERS SEEKING APPROVAL AS INDEPENDENT MEDICAL EXAMINERS - GENERAL PRACTITIONERS

MEDICAL PRACTITIONERS SEEKING APPROVAL AS INDEPENDENT MEDICAL EXAMINERS - GENERAL PRACTITIONERS MEDICAL PRACTITIONERS SEEKING APPROVAL AS INDEPENDENT MEDICAL EXAMINERS - GENERAL PRACTITIONERS 1. Personal Details What is your medical specialty (if any)? Title: Dr Mr Mrs Ms Other (please specify) Family

More information

APPLICATION FOR NEW CERTIFICATE OF COMPETENCE

APPLICATION FOR NEW CERTIFICATE OF COMPETENCE APPLICATION FOR NEW CERTIFICATE OF COMPETENCE This is an application form for a certificate of competence under the Health and Safety in Employment (Mining Operations and Quarrying Operations) Regulations

More information

APPLICATION TO AMEND A LIQUOR LICENCE OR PERMIT Liquor Act 2010 Liquor Regulations 2010 IMPORTANT

APPLICATION TO AMEND A LIQUOR LICENCE OR PERMIT Liquor Act 2010 Liquor Regulations 2010 IMPORTANT Page 1 of 15 APPLICATION TO AMEND A LIQUOR LICENCE OR PERMIT IMPORTANT This form is to be used to apply for an amendment to a current liquor licence or permit under the (the Act). You can access the legislation

More information

APPLICATION FOR ELIGIBILITY FOR DOMESTIC BUILDING INSURANCE

APPLICATION FOR ELIGIBILITY FOR DOMESTIC BUILDING INSURANCE VIC - Builders Warranty Insurance Business with Turnover below $5m Application Form Commercial & General Insurance Brokers (Aust) Pty Ltd Suite 4, 1016 Doncaster Road Doncaster East Victoria 3109 Phone:

More information

CHC30113 Certificate III in Early Childhood Education and Care

CHC30113 Certificate III in Early Childhood Education and Care ENROLMENT APPLICATION FORM CHC30113 Certificate III in Early Childhood Education and Care About this application Use this Enrolment Application to apply for enrolment in the CHC30113 Certificate III in

More information

APPLICATION TRANSITION FROM PROVISIONAL TO (FULL) REGISTRATION

APPLICATION TRANSITION FROM PROVISIONAL TO (FULL) REGISTRATION Member of the Australasian Teacher Regulatory Authorities Inc. PO Box 3649, Rundle Mall SA 5000 Phone: (08) 8226 2666 Fax: (08) 8226 2667 Website: www.trb.sa.edu.au Email: info@trb.sa.edu.au APPLICATION

More information

ALLIED HEALTH PRACTITIONERS SEEKING APPROVAL AS INDEPENDENT MEDICAL EXAMINERS

ALLIED HEALTH PRACTITIONERS SEEKING APPROVAL AS INDEPENDENT MEDICAL EXAMINERS ALLIED HEALTH PRACTITIONERS SEEKING APPROVAL AS INDEPENDENT MEDICAL EXAMINERS TRANSPORT ACCIDENT COMMISSION 1. Application Directed To Transport Accident Commission (TAC) WorkSafe Victoria (WorkSafe) Both

More information

ACCOUNT APPLICATION FORM & IDENTIFICATION FORM

ACCOUNT APPLICATION FORM & IDENTIFICATION FORM ACCOUNT APPLICATION FORM & IDENTIFICATION FORM This form may be used to apply for a new Account or to verify the identity of an existing Provisional account holder. INSTRUCTIONS Please complete Section

More information

WHOLE BALANCE TRANSFER TO A KIWISAVER SCHEME

WHOLE BALANCE TRANSFER TO A KIWISAVER SCHEME WHOLE BALANCE TRANSFER TO A KIWISAVER SCHEME Issued 1 November 2014 Please use this form to transfer your whole superannuation balance to a KiwiSaver scheme. Transferring only part of your superannuation

More information

NATIONAL POLICE HISTORY CHECK INFORMATION 2014. Western Australian Education and Training Sectors

NATIONAL POLICE HISTORY CHECK INFORMATION 2014. Western Australian Education and Training Sectors NATIONAL POLICE HISTORY CHECK INFORMATION 2014 Western Australian Education and Training Sectors HOW TO COMPLETE THE NATIONAL POLICE CHECKING SERVICE (NPCS) APPLICATION/CONSENT FORM Please read all information

More information

Advance Retirement Suite Super Early Release Financial Hardship Application

Advance Retirement Suite Super Early Release Financial Hardship Application Advance Retirement Suite Super Early Release Financial Hardship Application Trustee: BT Funds Management Ltd (BTFM) ABN 63 002 916 458 AFSL 233724 GUIDE TO COMPLETING THIS FORM > > Use this form if you

More information

Withdrawal Flexi Pension

Withdrawal Flexi Pension Fact sheet and form Withdrawal Flexi Pension You can make a full or partial lump sum withdrawal from your Flexi Pension account at any time. What this fact sheet covers This fact sheet explains the rules

More information

APPLICATION GUIDELINES Teacher registration

APPLICATION GUIDELINES Teacher registration APPLICATION GUIDELINES Teacher registration July 2013 GUIDELINES to completing the Application for Teacher Registration It is a legal requirement under the Education (Queensland College of Teachers) Act

More information

CORPORATE VOLUNTARY DIRECT DEBIT APPLICATION

CORPORATE VOLUNTARY DIRECT DEBIT APPLICATION CORPORATE VOLUNTARY DIRECT DEBIT APPLICATION 1. Please complete this form USING BLACK INK and write within the boxes in CAPITAL LETTERS. Mark appropriate answer boxes with a CROSS. Start at the left of

More information

CRIMINAL HISTORY CHECK APPLICATION

CRIMINAL HISTORY CHECK APPLICATION NORTHERN TERRITORY POLICE SAFE NT Phone 1800 723 368 (1800 SAFENT) Office Hours 8 30am 4 30pm Monday Thursday 9 30am 5 30pm Friday CRIMINAL HISTORY CHECK APPLICATION PF095 06/12 C APPLICATION FOR CRIMINAL

More information

Virgin Super How to transfer your super to New Zealand (Trans Tasman Portability)

Virgin Super How to transfer your super to New Zealand (Trans Tasman Portability) Logo to be inserted Virgin Super How to transfer your super to New Zealand (Trans Tasman Portability) NEED HELP? Please refer to the information and relevant websites detailed below. You can call the Customer

More information

Site Supervisor licence

Site Supervisor licence Build better. Site Supervisor licence QBCC s site supervisor licence was introduced to improve the standard and quality of supervision of building work and to provide an employee with a clear career path

More information

Complete this form to withdraw part or all of your benefit as a lump sum, roll over to another GESB account and/or to another complying super fund.

Complete this form to withdraw part or all of your benefit as a lump sum, roll over to another GESB account and/or to another complying super fund. Benefit access Gesb Super and West State Super SUP E R ANNUATION Complete this form to withdraw part or all of your benefit as a lump sum, roll over to another GESB account and/or to another complying

More information

Practitioner Indemnity Insurance Policy Application Form

Practitioner Indemnity Insurance Policy Application Form Practitioner Indemnity Insurance Policy Application Form Avant Mutual Group Limited ABN 58 123 154 898 Membership with Avant Mutual Group Limited ABN 58 123 154 898 Practitioner Indemnity Insurance with

More information

Application for Disability Lump Sum SERB Scheme

Application for Disability Lump Sum SERB Scheme Application for Disability Lump Sum SERB Scheme Who should use this form? You should complete this form if you are a SERB Scheme member who is applying for a Disability Lump Sum benefit. Did you know?

More information

Instruction Pages for a Victorian Private Security Business Application

Instruction Pages for a Victorian Private Security Business Application VP Form 1083 Instruction Pages for a Victorian Private Security Business Application How do I submit my application? Complete the form in blue or black pen only. Ensure that you print neatly in capital

More information

GE Money s Know Your Intermediary Broker Application

GE Money s Know Your Intermediary Broker Application GE Money s Know Your Intermediary Broker Application Application for accreditation with GE Money to introduce: Motor Loans Personal Loans* (Optional) In order to comply with the Know Your Intermediary

More information

Request to Increase Insurance Life Event

Request to Increase Insurance Life Event Request to Increase Insurance Life Event Accumulation Scheme (Division 5) members only Use this form to apply to increase your insurance cover when a specific life event has occurred. As an accumulation

More information

VIC - Owner Builder - Home Warranty Insurance Application Form

VIC - Owner Builder - Home Warranty Insurance Application Form Commercial & General Insurance Brokers (Aust) Pty Ltd Suite 4, 1016 Doncaster Road Doncaster East Victoria 3109 Phone: 1300 764 244 Fax: 03 8841 4299 Email: home.warranty@cgib.com.au Web: www.cgib.com.au

More information

GE Money s Know Your Intermediary Personal Loan Broker Application

GE Money s Know Your Intermediary Personal Loan Broker Application GE Money s Know Your Intermediary Personal Loan Broker Application In order to comply with the Know Your Intermediary (KYI) requirements of GE Money for the introduction of personal loans, the following

More information

APPLICATION FOR A LICENCE Security & Related Activities (Control) Act 1996

APPLICATION FOR A LICENCE Security & Related Activities (Control) Act 1996 Security & Related Activities (Control) Act 1996 Instructions to applicants follow all of these steps to complete your application You must carefully complete all sections and attach all required documents.

More information

Portability and rollover

Portability and rollover Fact sheet and form Portability and rollover What this fact sheet covers This fact sheet explains how to make a rollover of all or part of your UniSuper account to another complying super fund. Who is

More information

Fixed insurance cover

Fixed insurance cover Fact sheet and form Fixed insurance cover When it comes to insurance cover, one size doesn t necessarily fit all. That s why you have the ability to convert your Death and Total & Permanent Disablement

More information

Application for a Certificate of Approval

Application for a Certificate of Approval Private Security Personnel Licensing Authority For more information visit www.pspla.govt.nz Application for a Certificate of Approval Under the Private Security Personnel and Private Investigators Act

More information

APPLICATION FOR ASSESSMENT: Special Education Teacher (not elsewhere classified) (ANZSCO 241599)

APPLICATION FOR ASSESSMENT: Special Education Teacher (not elsewhere classified) (ANZSCO 241599) Effective: 01 January 2014 APPLICATION FOR ASSESSMENT: Special Education Teacher (not elsewhere classified) (ANZSCO 241599) The Australian Institute for Teaching and School Leadership (AITSL) Ltd has been

More information

Couriers insurance package form

Couriers insurance package form Page 1 of 5 Couriers insurance package form Important Information Duty of Disclosure Before you enter into a contract of insurance, you have a duty under the Insurance Contracts Act 1984 (Cth) to disclose

More information

Macquarie Mortgages Application for Finance

Macquarie Mortgages Application for Finance Macquarie Mortgages Application for Finance New application (stand-alone deal) Variation Principal increase Personal Details Applicant 1 Personal Details Applicant 2 Borrower Guarantor (please tick one

More information

Instruction Pages Individual Private Security Licence Application

Instruction Pages Individual Private Security Licence Application Please remove Instruction Pages before submitting your application VP Form 1080 Instruction Pages Individual Private Security Licence Application Security Guard, Crowd Controller, Investigator or Bodyguard

More information

Identification GETTING STARTED

Identification GETTING STARTED Identification GETTING STARTED 3 This is Booklet 3 in the Getting Started Series. Getting Started is a guide for people leaving prison. Booklets 1 The First Week 2 Housing 3 Identification 4 Alcohol and

More information

APPLICATION FOR ESTABLISHMENT OF A SELF MANAGED SUPERANNUATION FUND

APPLICATION FOR ESTABLISHMENT OF A SELF MANAGED SUPERANNUATION FUND APPLICATION FOR ESTABLISHMENT OF A SELF MANAGED SUPERANNUATION FUND Fund Details: What is the name of the Fund:... (Any name can be used as there is no identical names check for superannuation funds) Contact

More information

PERSONAL INJURY CLAIM FORM

PERSONAL INJURY CLAIM FORM Office use only Policy Number: AN A038364 PAD Claim Number: PERSONAL INJURY CLAIM FORM INSURANCE BROKER FOR TRIATHLON AUSTRALIA V-Insurance Group Pty Ltd Level 28, Angel Place, 123 Pitt Street, SYDNEY

More information

Lump sum benefit payment request for your superannuation or account based pension

Lump sum benefit payment request for your superannuation or account based pension Lump sum benefit payment request for your superannuation or account based pension How to claim a benefit To claim a benefit you will need to complete the attached Benefit Payment Request and send it direct

More information

Property Claim Report

Property Claim Report Property Claim Report This form is to be used for reporting a claim for lost, stolen or damaged property, including: Accidental damage Illegal use of credit card Accidental loss Impact Burglary Lightning

More information

Architects Accreditation Council of Australia. Regulation of the Architect Profession within Australia An Overview

Architects Accreditation Council of Australia. Regulation of the Architect Profession within Australia An Overview Architects Accreditation Council of Australia Regulation of the Architect Profession within Australia An Overview February 2015 Table of Contents 1. Introduction... 3 2. Registration Requirements for Individuals...

More information

Wholesale Australian Property Fund and Australian Property Fund Application form

Wholesale Australian Property Fund and Australian Property Fund Application form Office use only Wholesale Australian Property Fund and Australian Property Fund Application form Issuer and responsible entity: National Mutual Funds Management Ltd ABN 32 006 787 720, AFSL 234652 National

More information

Credit Card Application Form for GPRA Members

Credit Card Application Form for GPRA Members Credit Card Application Form for GPRA Members Credit Card Application Form for GPRA Members Please complete your details and return by email to RACGP@boqspecialist.com.au or alternatively by post to BOQ

More information

Postcode: Postcode: Australia Business Number (ABN):

Postcode: Postcode: Australia Business Number (ABN): New client form Name of your AJ Park contact: Account name: Trading name: Full name of contact person: Mobile: Street address: Postcode: Postal address (if different from street address): Postcode: Phone:

More information