ISPC: Transfer. Instructions. LOSING signalling point operator. Reason for transferring an ISPC. Details of ISPC

Size: px
Start display at page:

Download "ISPC: Transfer. Instructions. LOSING signalling point operator. Reason for transferring an ISPC. Details of ISPC"

Transcription

1 ISPC: Transfer Instructions Complete this form to notify the ACMA of a transfer an International Signalling Point Code (ISPC) between international signalling point operators. This form has separate sections for the losing and the gaining signalling point operators to complete. Print clearly as illegible, unclear or incomplete application forms may delay processing. The completed forms may be forwarded to the ACMA via: Fax: (03) ; or 3. Mail: Carrier Infrastructure & Monitoring Section, PO Box Law Courts, Melbourne Vic 8010 Enquiries about ISPC should be directed to: Carrier Infrastructure & Monitoring Section Tel: (03) ; or Reason for transferring an ISPC Identify the reason for the ISPC transfer. 1. Is the transfer of the ISPC due to divestment by the operator that was initially allocated the code? Yes No 2. Is the transfer due to a merger, acquisition or joint venture of the operator initially allocated the ISPC? Yes No LOSING signalling point operator (Gaining signalling point operations should complete the section on page 2) Name of applicant ACN or ARBN number (IF APPLICABLE) Contact person Registered business name (IF DIFFERENT TO ABOVE) SURNAME GIVEN NAMES Postal address Contact details WORK ( ) MOBILE FAX ( ) Registered business address (IF DIFFERENT) Details of ISPC ISPC(s) Unique name(s) Location (address) of the signalling point Date of transfer ACMA form T041 Page 1 February 2015

2 Has the information given to the ACMA by the operator changed since the original application for the ISPC(s)? If so, outline the changes. Note: This information relates to details supplied under sub section 5A.6 (1) of the Plan. Declaration I certify that the information provided in this application, together with any other information submitted as a part of this application, is true and correct. I am aware that under section of the Criminal Code Act 1995 it is an offence to knowingly make a false or misleading statement to a Commonwealth entity in connection with the making of an application. SIGNATURE OF AUTHORISED PERSON PRINT FULL NAME DATE POSITION IN ORGANISATION GAINING signalling point operator Name of applicant ACN or ARBN number (IF APPLICABLE) Contact person Registered business name (IF DIFFERENT TO ABOVE) SURNAME GIVEN NAMES Postal address Contact details WORK ( ) MOBILE FAX ( ) Registered business address (IF DIFFERENT) Intended use of the ISPC 1 2 Quantity Unique name of signalling point End date (if temporary only) Specify what the applicant will use the ISPC for. Signalling transfer point Signalling end point (signalling point without signalling transfer point function) Signalling connection control part relay ACMA form T041 Page 2 February 2015

3 International switching centre Gateway mobile switching centre Location register Operation and maintenance centre Service control point Service switching point Other Explain how the ISPC will be used and if there are any changes from the previous holder (e.g. such as a change of physical location of the signalling point). Declaration I certify that the information provided in this application, together with any other information submitted as a part of this application, is true and correct. I am aware that under section of the Criminal Code Act 1995 it is an offence to knowingly make a false or misleading statement to a Commonwealth entity in connection with the making of an application. SIGNATURE OF AUTHORISED PERSON PRINT FULL NAME DATE POSITION IN ORGANISATION Note: The information that must be provided on or with this form is being sought for the purposes of considering applications for numbers under the Plan and to enable the ACMA to perform its telecommunications functions under section 8 of the Australian Communications and Media Authority Act Applicants should also note that the name of the organisation will be included on the register to be maintained by the ACMA under section 465 of the Telecommunications Act 1997, by virtue of which the register will be open to inspection by the public at the following web link; ACMA form T041 Page 3 February 2015

4 General information An International Signalling Point Code (ISPC) is a unique, five-digit code used to identify an international signalling point associated with a specific international signalling point operator. A signalling point or node may be an exchange or a switching centre, and can be understood as the point in the network at which signals or messages either originate or are received. In the case of international signals, the signalling point is an international gateway. Signalling information is passed over the signalling link (i.e. the channel between signalling points or nodes). Signals are transmitted continuously in both directions on any link that is in service. The message transfer points provide reliable end-to-end connectivity for a single link. It provides accurate end-to-end transmission of a message across a signalling link, and implements flow control, message sequence validation and error checking. It also includes capabilities as node addressing, routing, alternative routing and congestion control. ISPCs are used by network operators to manage the efficient routing and delivery of calls, and to separate the voice portion of a call (i.e. voice circuits) from the management of a call. The signalling layer in the network manages such things as identifying whether a called number is in use, the route a call will take, and delivers customer features such as receiving a call-waiting tone and automatically redialling the last number called. ISPCs are administered by the ACMA according to International Telecommunication Union (ITU) Recommendation Q.708, which sets out the assignment procedures for ISPCs. The ACMA manages ISPC allocation in Australia. The rules for managing ISPCs in Australia are set out in Chapter 5A of the Telecommunications Numbering Plan 1997 (the Plan). Transferring an ISPC Eligibility (see sections 5A.21) There are two circumstances only where an ISPC can be transferred to another entity: if the signalling point operator to which the ISPC was allocated divests the part of the entity that is the signalling point operator to a separate or new entity; or if the signalling point operator to which the ISPC was allocated merges with, is acquired by, or enters a joint venture with another entity. If neither of these circumstances is applicable, contact the ACMA for further information. Application charge There is no charge to transfer ISPCs. Information required (see sections 5A.6, 5A.19 & 5A.20) The Plan requires a joint written notification of the transfer of an ISPC. The notification must be filled in and signed by both the losing and gaining signalling point operators. Losing signalling point operator The losing signalling point operator must provide details of the ISPC allocated to it. The information required from the losing signalling point operator is: the number of the ISPC the unique name of the signalling point the location of the ISPC (e.g. Melbourne) the date of the divestment, merger, acquisition or joint venture The losing signalling point operator should also identify whether the use of the ISPC has changed since it was originally allocated and, if so, how. Gaining signalling point operator The gaining signalling point operator must identify how it intends to use the ISPC. ISPCs may be used to temporarily in a test network, or may be allocated for use for a range of uses including signalling transfer point, location register and service control point. An ISPC may be used for more than one purpose. It is expected that only one ISPC per applicant will be used to provide the same service (e.g. as location register) per signalling point. For an ISPC allocated temporarily for use in a test network, the number of the ISPC, the name of the test network and the return date must be provided. For all other requests for ISPCs, the information required includes: information demonstrating that the signalling point operator has, or will as soon as practicable have, an effective signalling relationship with at least one other international signalling point that will allow a message to be transferred for an ISPC which is packet switched, the ISPC, the primary address of the signalling point (i.e. its unique name), for the location of the signalling point (e.g. Melbourne) and the date by which the ISPC will be in service ACMA form T041 Page 4 February 2015

5 for an ISPC which is not packet switched, the ISPC, the address of the signalling point (i.e. its unique name), the location of the signalling point (e.g. Melbourne) and the date by which the ISPC will be in service Acknowledgement The ACMA s practice is to notify the two parties of receipt of the notification and notify the ITU of the new allocatee. Effective date of transfer (see sections 5A.19 & 5A.20) An ISPC is considered to be allocated to the new entity on the day of the divestment, merger, acquisition or commencement of a joint venture. ACMA form T041 Page 5 February 2015

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care.

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care. Aged Care Education and Training Incentive Programme COMPLETION PAYMENT This application form is to be completed by applicants who have completed studies and have already received a commencement payment

More information

Application for Digital Radio Multiplex Transmitter apparatus licence(s) Form R058 (In accordance with section 99 of the Radiocommunications Act 1992)

Application for Digital Radio Multiplex Transmitter apparatus licence(s) Form R058 (In accordance with section 99 of the Radiocommunications Act 1992) Application for Digital Radio Multiplex Transmitter apparatus licence(s) Form R058 (In accordance with section 99 of the Radiocommunications Act 1992) Use of form and instructions This form is to be used

More information

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care.

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care. Aged Care Education and Training Incentive Programme COMMENCEMENT PAYMENT This application form is to be completed by eligible aged care workers who have enrolled and commenced studies to enhance their

More information

Claim for Special Child Care Benefit and/or increased weekly limit of hours

Claim for Special Child Care Benefit and/or increased weekly limit of hours Claim for Special Child Care Benefit and/or increased weekly limit of hours When to use this form Special Child Care Benefit (rate) for hardship, and/or Increased weekly limit of hours due to exceptional

More information

Application Form FOR AN ELECTRICITY LICENCE UNDER THE ELECTRICITY SUPPLY INDUSTRY ACT 1995. Version: Issue No. 5

Application Form FOR AN ELECTRICITY LICENCE UNDER THE ELECTRICITY SUPPLY INDUSTRY ACT 1995. Version: Issue No. 5 Application Form FOR AN ELECTRICITY LICENCE UNDER THE ELECTRICITY SUPPLY INDUSTRY ACT 1995 Version: Issue No. 5 July 2014 1. INFORMATION FOR APPLICANTS 1.1 Purpose of this form This form is to be completed

More information

Questionnaire Cornwell-Type Claims

Questionnaire Cornwell-Type Claims Sensitive: Personal once completed Questionnaire Cornwell-Type Claims Please complete all sections of this form and enter N/A in any section that is not applicable to indicate that the question has been

More information

Energy Efficient Homes Package

Energy Efficient Homes Package Energy Efficient Homes Package Solar Hot Water Rebate Applicant Information Booklet The Australian Government's $3.9 billion Energy Efficient Homes Package aims to improve the energy rating of Australian

More information

Change of address and/or passport details

Change of address and/or passport details Change of address and/or details Form 929 ImmiAccount You can now update your address and details online via your ImmiAccount available on the Department of Immigration and Border Protection (the ) website

More information

Form Workers compensation claim form

Form Workers compensation claim form Form Workers compensation claim form Part 1 of the claim form is to be filled in by the worker. The following information is provided as guidance to workers filling in Part 1 Notify your employer of your

More information

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

Part 1 To be filled in by the worker. The following information is provided as guidance to workers filling in Part 1.

Part 1 To be filled in by the worker. The following information is provided as guidance to workers filling in Part 1. Form Workers compensation claim form Part 1 To be filled in by the worker. The following information is provided as guidance to workers filling in Part 1. Notify your employer of your injury or disease

More information

PERSONAL DETAILS BASIS FOR APPLICATION

PERSONAL DETAILS BASIS FOR APPLICATION APPLICATION FM (for transitional arrangements only) APS SUPERVISED PRACTICE ASSOCIATE MEMBER - MASTERS ROUTE APS COLLEGES PERSONAL DETAILS Dr c Mr c Mrs c Ms c Miss c Other c Family name: Former name (if

More information

Professional Indemnity Insurance Application

Professional Indemnity Insurance Application Professional Indemnity Insurance Application Office Use Only Core Customer Segment Account Number Policy Number Important Notices Duty of Disclosure Before you enter into a contract of insurance with Ansvar

More information

Specialists at minimising risk exposure. Professional Indemnity Insurance Insurance Proposal Form

Specialists at minimising risk exposure. Professional Indemnity Insurance Insurance Proposal Form Specialists at minimising risk exposure Professional Indemnity Insurance Insurance Proposal Form Professional Indemnity Insurance Application Office Use Only Core Customer Segment Account number Policy

More information

Workers Compensation claim form

Workers Compensation claim form Form Workers Compensation claim form STOP - this form is available to be filled in electronically on the NT WorkSafe web site www.worksafe.nt.gov.au. Fill the form in electronically then save a copy to

More information

CLAIM FOR TRANSPORT SUBSIDY FOR ANIMAL WELFARE

CLAIM FOR TRANSPORT SUBSIDY FOR ANIMAL WELFARE CLAIM FOR TRANSPORT SUBSIDY FOR ANIMAL WELFARE NOTE: Submit all claim forms with original invoices, receipts and other documents attached. All invoices will be copied and returned to the claimant. Initial

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

Privacy Policy. 30 January 2015

Privacy Policy. 30 January 2015 Privacy Policy 30 January 2015 Table of Contents 1 Overview 3 Purpose 3 Scope 3 2 Collection 3 What information do we collect? 3 What if you do not give us the information we request? 4 3 Use of information

More information

Part A: Personal Declaration Form to be completed by applicants.

Part A: Personal Declaration Form to be completed by applicants. ACT Revenue Office Application for an ACT Mortgage Relief Loan NOTES Applicants must read and understand the Terms and Conditions at the end of this form. If the conditions of eligibility are not met,

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

QUOTATION REQUEST WESTERN AUSTRALIA. How long has the business been in the WA? New 1 4 Yrs 5 8 Yrs 8 Yrs Plus

QUOTATION REQUEST WESTERN AUSTRALIA. How long has the business been in the WA? New 1 4 Yrs 5 8 Yrs 8 Yrs Plus QUOTATION REQUEST WESTERN AUSTRALIA CUSTOMER DETAILS Contact Name: Business Phone: E-mail Address: Position / Title: Fax Number: Mobile: Full Name of Company / Sole Proprietor / Partnership / Trust / Other

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

Notice of intent. Fact sheet and form. What this fact sheet covers. Who is this fact sheet for? When should I complete a notice of intent?

Notice of intent. Fact sheet and form. What this fact sheet covers. Who is this fact sheet for? When should I complete a notice of intent? Fact sheet and form Notice of intent A notice of intent to claim or vary a deduction for personal super contributions (notice of intent) allows you to claim a tax deduction for your personal contributions,

More information

Instructions and form for individuals living outside Australia. Tax file number application or enquiry for individuals living outside Australia

Instructions and form for individuals living outside Australia. Tax file number application or enquiry for individuals living outside Australia Instructions and form for individuals living outside Australia Tax file number application or enquiry for individuals living outside Australia NAT 2628 04.2014 INTRODUCTION YOUR TAX FILE NUMBER (TFN) AND

More information

Home Warranty Insurance eligibility application

Home Warranty Insurance eligibility application Home Warranty Insurance eligibility application Please ensure all questions are completed and the declaration at the end of this form is signed prior to lodgement with your insurance broker. For any assistance

More information

Statutory Declaration

Statutory Declaration Statutory Declaration Organisations must complete and submit this Statutory Declaration to the Australian Government Department of Education (the department), through the HELP IT System (HITS), when there

More information

Application for Overdraft, Personal or Car loan

Application for Overdraft, Personal or Car loan Application for Overdraft, Personal or Car loan How to lodge your application: bankvic.com.au loans@bankvic.com.au 13 63 73 option 4 Reply Paid 669, BankVic PO Box 669, Carlton Sth Vic 3053 Visit a branch

More information

Department of Education and Training

Department of Education and Training Department of Education and Training 2016 Living Away from Home Allowances Scheme (LAFHAS) Application Form 2016 this application form is to be completed in conjunction with reading the Living Away from

More information

QUOTATION REQUEST TASMANIA. How long has the business been in the TAS? New 1 4 Yrs 5 8 Yrs 8 Yrs Plus. Current Insurer: Expiry Date: / /

QUOTATION REQUEST TASMANIA. How long has the business been in the TAS? New 1 4 Yrs 5 8 Yrs 8 Yrs Plus. Current Insurer: Expiry Date: / / QUOTATION REQUEST TASMANIA CUSTOMER DETAILS Contact Name: Business Phone: E-mail Address: Position / Title: Fax Number: Mobile: Full Name of Company / Sole Proprietor / Partnership / Trust / Other (Legal

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

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

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 for a community television broadcasting licence (in the broadcasting services bands)

Application for a community television broadcasting licence (in the broadcasting services bands) Application for a community television broadcasting licence (in the broadcasting services bands) Lodgement information Print clearly. Illegible, unclear or incomplete application details may delay processing.

More information

GIO Workers Compensation Australian Capital Territory

GIO Workers Compensation Australian Capital Territory GIO Workers Compensation Australian Capital Territory Employee s claim form Employer s policy number: Complete all questions fully and accurately, to ensure accurate decisions can be made about your claim.

More information

PROOF OF ABORIGINALITY OR TORRES STRAIT ISLANDER DESCENDANTS FORM

PROOF OF ABORIGINALITY OR TORRES STRAIT ISLANDER DESCENDANTS FORM PROOF OF ABORIGINALITY OR TORRES STRAIT ISLANDER DESCENDANTS FORM INTRODUCTION Broome Regional Aboriginal Medical Service requires applicants to provide evidence of their Aboriginal and Torres Strait Islander

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

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

Defence Bank Pension Pension Tax File Number Declaration

Defence Bank Pension Pension Tax File Number Declaration Defence Bank Pension Pension Tax File Number Declaration < Instructions This declaration is NOT an application for a tax file number. Please print neatly in BLOCK LETTERS and use a BLACK pen. Print X in

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

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

Home Warranty Insurance Claim Form

Home Warranty Insurance Claim Form Home Warranty Insurance Claim Form General WFI Insurance Limited (ABN 24 000 036 279) trading as Lumley Insurance offers Builders Home Warranty Insurance to owner Builders and Licensed Builders in the

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

Application for Prioritisation of a Plant Import Industry Proposal

Application for Prioritisation of a Plant Import Industry Proposal Application for Prioritisation of a Plant Import Industry Proposal The following form is to be completed by the applicant and submitted to DEPARTMENT OF AGRICULTURE for priority setting. An applicant may

More information

HOME WARRANTY INSURANCE ELIGIBILITY APPLICATION

HOME WARRANTY INSURANCE ELIGIBILITY APPLICATION HOME WARRANTY INSURANCE ELIGIBILITY APPLICATION Please ensure all questions are completed and the declaration at the end of this form is signed prior to lodgement with your insurance broker. For any assistance

More information

Fact Sheet > Super SA > Triple S > Your Questions Answered MAKING AN INCOME PROTECTION CLAIM

Fact Sheet > Super SA > Triple S > Your Questions Answered MAKING AN INCOME PROTECTION CLAIM Fact Sheet > Super SA > Triple S > Your Questions Answered MAKING AN INCOME PROTECTION CLAIM > 1 IN THIS FACT SHEET > What is Income Protection (IP)? > Circumstances under which IP will not be paid > Step

More information

CLAIM FORM. "SELLING CLIENT" (Regulations 7.5.24 and 7.5.25 Corporations Regulations 2001) (Subdivision 4.3) WHERE TO SEND YOUR CLAIM FORM

CLAIM FORM. SELLING CLIENT (Regulations 7.5.24 and 7.5.25 Corporations Regulations 2001) (Subdivision 4.3) WHERE TO SEND YOUR CLAIM FORM SECURITIES EXCHANGES GUARANTEE CORPORATION LTD ABN 19 008 626 793 Trustee of the National Guarantee Fund ABN 69 546 559 493 Level 7, Exchange Centre, 20 Bridge Street Sydney NSW 2000 "SELLING CLIENT" (Regulations

More information

Street Address Suburb State Postcode. Suburb Section Block Property address Postcode

Street Address Suburb State Postcode. Suburb Section Block Property address Postcode ACT Revenue Office ABN: 45 096 207 205 Application for Discount Land Rent (for land rent leases first granted prior to 1 October 2013) NOTES This form should only be completed if the lessees entered the

More information

Blue Care Income Protection Claim Form

Blue Care Income Protection Claim Form Blue Care Income Protection Claim Form INCOME PROTECTION CLAIMS In order to alleviate any delay in the processing time of your claim, please ensure the following: The claim form is returned with all fields

More information

DIRECTORS & OFFICERS LIABILITY INSURANCE PROPOSAL FORM IMPORTANT INFORMATION: PLEASE READ THE FOLLOWING INFORMATION BEFORE COMPLETING THIS PROPOSAL

DIRECTORS & OFFICERS LIABILITY INSURANCE PROPOSAL FORM IMPORTANT INFORMATION: PLEASE READ THE FOLLOWING INFORMATION BEFORE COMPLETING THIS PROPOSAL DIRECTORS & OFFICERS LIABILITY INSURANCE PROPOSAL FORM IMPORTANT INFORMATION: PLEASE READ THE FOLLOWING INFORMATION BEFORE COMPLETING THIS PROPOSAL A. Obtaining a Quotation To minimise delays in obtaining

More information

Application for Admission to QUT as an International Student in a Research Program

Application for Admission to QUT as an International Student in a Research Program Queensland University of Technology Student Business Services Victoria Park Road Kelvin Grove Qld 4059 Australia Phone 07 3138 2000 Fax +61 7 3138 3529 www.international.qut.edu.au CRICOS No. 00213J ABN

More information

4) All original items submitted become the property of the Louisiana Department of Insurance and will not be returned.

4) All original items submitted become the property of the Louisiana Department of Insurance and will not be returned. JAMES J. DONELON COMMISSIONER OF INSURANCE STATE OF LOUISIANA P.O. Box 94214 Baton Rouge, Louisiana 70804-9214 Phone (225) 342-5900 Fax (225) 342-3078 http://wwwldi.ldi.state.la.us INSTRUCTIONS FOR REGISTRATION

More information

Application for accreditation as a recognised BAS agent association

Application for accreditation as a recognised BAS agent association Application for accreditation as a recognised BAS agent association Completing this application form You will need to have read the information sheet Recognised BAS agent association before completing

More information

Thank you for contacting CGU Insurance

Thank you for contacting CGU Insurance Make a Trauma Claim Thank you for contacting CGU Insurance You must have access to a printer in order to access this form. If you do not have access to a printer please contact our office on 1800 248 224

More information

Request for VET FEE-HELP assistance

Request for VET FEE-HELP assistance Before completing this form, you must read the VET FEE-HELP information booklet, available at www.studyassist.gov.au. You must: complete this form if you are requesting for all or part of your VET tuition

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

NT WORKERS COMPENSATION CLAIM FORM

NT WORKERS COMPENSATION CLAIM FORM Information for Workers Guidance to PART 1 of the Claim Form Notify your employer of your injury, verbally or in writing, as soon as practicable. Fully complete PART 1 (questions 1 to 8) of the following

More information

TENANCY APPLICATION FORM

TENANCY APPLICATION FORM Domain Charter Group Pty Ltd. ABN 95 102 392 254. ACN 102 392 254 Level 1, 437 Canterbury Road Surrey Hills VIC 3127 Tel: 03 8888 8888 Fax: 03 8888 8800 Email: reception@domaincharter.com.au TENANCY APPLICATION

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

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

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

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

RULES FOR FILING A CLAIM AND APPEAL RIGHTS

RULES FOR FILING A CLAIM AND APPEAL RIGHTS DIVISION OF TEMPORARY DISABILITY INSURANCE APPLICATION FOR FAMILY LEAVE INSURANCE BENEFITS (FL-1) DETACH THIS PAGE AND KEEP FOR YOUR RECORDS RULES FOR FILING A CLAIM AND APPEAL RIGHTS 1. It is your responsibility

More information

Join GMHBA Transfer from an existing GMHBA membership Change my GMHBA cover

Join GMHBA Transfer from an existing GMHBA membership Change my GMHBA cover Application form September 2012 1. I wish to (please tick) Join GMHBA Transfer from an existing GMHBA membership Change my GMHBA cover GMHBA member number (existing members only) Cover or change of cover

More information

Salesforce.com Inpatriate Health Plan Application Form

Salesforce.com Inpatriate Health Plan Application Form G U 0 0 0 0 0 1 Salesforce.com Inpatriate Health Plan Application Form GU Health Membership No. (if you have one): Cover commencement date or change of cover date: I wish to (please indicate with an X):

More information

Builders Warranty Claim Form

Builders Warranty Claim Form Builders Warranty Claim Form IMPORTANT NOTICES About the Insurer This insurance is underwritten by Great Lakes Reinsurance (UK) SE (ARBN 127 740 532, ABN 18 964 580 576, AFSL 318603) trading as Great Lakes

More information

STATUTORY INSTRUMENTS. S.I. No. 336 of 2011

STATUTORY INSTRUMENTS. S.I. No. 336 of 2011 STATUTORY INSTRUMENTS. S.I. No. 336 of 2011 EUROPEAN COMMUNITIES (ELECTRONIC COMMUNICATIONS NETWORKS AND SERVICES) (PRIVACY AND ELECTRONIC COMMUNICATIONS) REGULATIONS 2011 (Prn. A11/1165) 2 [336] S.I.

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

Model disclosure document for franchisee or prospective franchisee

Model disclosure document for franchisee or prospective franchisee Model disclosure document for franchisee or prospective franchisee The following pages give a recommended format for a disclosure document for a franchisee or prospective franchisee in accordance with

More information

Application for Visa Credit card

Application for Visa Credit card Application for Visa Credit card How to lodge your application: bankvic.com.au loans@bankvic.com.au 13 63 73 option 4 Reply Paid 669, BankVic PO Box 669, Carlton Sth Vic 3053 Visit a branch Information

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

Deduction for personal super contributions

Deduction for personal super contributions Instructions for super fund members Deduction for personal super contributions How to complete your Notice of intent to claim or vary a deduction for personal super contributions This form should only

More information

SENSIS CORPORATE HEALTH PLAN

SENSIS CORPORATE HEALTH PLAN SENSIS CORPORATE HEALTH PLAN The Health Insurer - Navy Health The health insurer for the Sensis Health Plan is Navy Health - a not-for-profit, member based Fund. Navy Health is one of Australia s restricted

More information

Guide for applicants for admission as a lawyer in NSW

Guide for applicants for admission as a lawyer in NSW Legal Profession Admission Board Guide for applicants for admission as a lawyer in NSW in accordance with the Legal Profession Uniform Admission Rules 2015 Version 1.3 9 December 2015 1. Introduction...

More information

` Instructions for Completing the Service Provider and Billed Entity Identification Number and Contact Information Form

` Instructions for Completing the Service Provider and Billed Entity Identification Number and Contact Information Form ` Instructions for Completing the Service Provider and Billed Entity Identification Number and Contact Information Form The FCC Form 498 is used to collect contact, remittance, and payment information

More information

Contact: ACT Health Nursing & Midwifery Scholarship Team Nursing & Midwifery Office Level 3, Building 6 Canberra Hospital PO Box 11 Woden ACT 2606

Contact: ACT Health Nursing & Midwifery Scholarship Team Nursing & Midwifery Office Level 3, Building 6 Canberra Hospital PO Box 11 Woden ACT 2606 ACT Health Nursing & Midwifery Post Graduate Scholarship Scheme Guidelines & Information: 2016 Contact: ACT Health Nursing & Midwifery Scholarship Team Nursing & Midwifery Office Level 3, Building 6 Canberra

More information

Westpac Business Debit MasterCard Application

Westpac Business Debit MasterCard Application Westpac Business Debit MasterCard Application Westpac Banking Corporation ABN 33 007 457 141 AFSL and Australian credit licence 233714 In order to apply for a Westpac Business Debit MasterCard, the following

More information

Tax file number application or enquiry for an individual

Tax file number application or enquiry for an individual Tax file number application or enquiry for an individual ABOUT TAX FILE NUMBERS The tax file number (TFN) is a unique number issued by the Tax Office to individuals and organisations to help the Tax Office

More information

Asbestos Contractors Pollution Liability Insurance Proposal

Asbestos Contractors Pollution Liability Insurance Proposal Asbestos Contractors Pollution Liability Insurance Proposal American Home Assurance Company ABN 67 007 483 267 AFSL 230903 Trading as AIG Australia (Incorporated with limited liability in the USA) A Member

More information

CLAIM FOR COMPENSATION FOR A WORK-RELATED DEATH

CLAIM FOR COMPENSATION FOR A WORK-RELATED DEATH CLAIM FOR COMPENSATION FOR A WORK-RELATED DEATH Seafarers Rehabilitation and Compensation Act 1992 Information about claiming compensation In this document, all references to the employer mean the employer

More information

Application for adoption information: Relative or guardian of adopted person who is deceased or does not have capacity

Application for adoption information: Relative or guardian of adopted person who is deceased or does not have capacity The purpose of the application for adoption information: is deceased or does not have capacity form This form is for use by a relative or guardian of an adult adopted person to apply for adoption information

More information

[Director] or [Secretary]

<Name> [Director] or [Secretary] <Name of organisation> <Address> <Address> 11 January 2008 [Director] or [Secretary] Dear INVITATION TO SUBSCRIBE FOR SHARES AND BECOME A MEMBER OF AN ELIGIBLE DIGITAL REPRESENTATIVE COMPANY

More information

Change My Insurance Details Form

Change My Insurance Details Form Change My Insurance Details Form Please complete and return this form to: NESS Super, Locked Bag 20, Parramatta NSW 2124 Complete in pen using CAPITAL letters or type directly into this form and print

More information

PREPARING FOR YOUR WEB HOSTING SERVICE

PREPARING FOR YOUR WEB HOSTING SERVICE PREPARING FOR YOUR WEB HOSTING SERVICE PREPARING FOR SERVICE ACTIVATION 1. It is your responsibility to ensure that all correct and relevant information is provided to Ascensa Communications in order for

More information

1. Public Switched Telephone Networks vs. Internet Protocol Networks

1. Public Switched Telephone Networks vs. Internet Protocol Networks Internet Protocol (IP)/Intelligent Network (IN) Integration Tutorial Definition Internet telephony switches enable voice calls between the public switched telephone network (PSTN) and Internet protocol

More information

APPLICATION FOR A TRADESPERSON S CERTIFICATE Motor Dealers and Repairers Act 2013

APPLICATION FOR A TRADESPERSON S CERTIFICATE Motor Dealers and Repairers Act 2013 Fee: $67 For 3 year registration ABN 81 913 830 179 APPLICATION FOR A TRADESPERSON S CERTIFICATE Motor Dealers and Repairers Act 2013 Apply using this application form OR apply online at www.licence.nsw.gov.au

More information

AAPT Business Inbound Voice

AAPT Business Inbound Voice AAPT Business Inbound Voice Service Schedule An AAPT Data & Networking Solution This Service Schedule forms part of the Agreement between Us and You and cannot be used as a stand-alone agreement. Any terms

More information

Personal Injury Claim Form

Personal Injury Claim Form Personal Injury Claim Form A.I.D.K.A AUSTRALIAN INDEPENDENT DIRT KART ASSOCIATION POLICY NUMBER 5494580 Correct completion of these forms will assist us to make accurate and faster decisions regarding

More information

Frequently Asked Questions for Students undertaking clinical placements. NSW Health Criminal Record Check requirements

Frequently Asked Questions for Students undertaking clinical placements. NSW Health Criminal Record Check requirements 1 Which students are covered by these requirements?... 3 2 What do I need to provide to NSW Health to undertake clinical placements?... 3 3 Is a National Police Check Certificate issued by a private company

More information

Once you have submitted the online medical assessment you will receive an online reference number. ONLINE REFERENCE NUMBER Smartform number

Once you have submitted the online medical assessment you will receive an online reference number. ONLINE REFERENCE NUMBER Smartform number To the medical practitioner, Please complete the online section of this form if you deem your patient to have a permanent and severe physical, intellectual, sensory or psychological disability that is

More information

Guide to assist you in completing the Application to Civil Claims List

Guide to assist you in completing the Application to Civil Claims List Civil Claims List Civil Division Guide to assist you in completing the Application to Civil Claims List Before you make an application This guide contains information about making a claim at VCAT in the

More information

REAL ESTATE AGENTS PROFESSIONAL INDEMNITY PROPOSAL FORM IMPORTANT INFORMATION: PLEASE READ THE FOLLOWING INFORMATION BEFORE COMPLETING THIS PROPOSAL

REAL ESTATE AGENTS PROFESSIONAL INDEMNITY PROPOSAL FORM IMPORTANT INFORMATION: PLEASE READ THE FOLLOWING INFORMATION BEFORE COMPLETING THIS PROPOSAL REAL ESTATE AGENTS PROFESSIONAL INDEMNITY PROPOSAL FORM IMPORTANT INFORMATION: PLEASE READ THE FOLLOWING INFORMATION BEFORE COMPLETING THIS PROPOSAL A. Your Duty of Disclosure Before you enter into an

More information

TREE MINOR WORKS PERMIT

TREE MINOR WORKS PERMIT TREE MINOR WORKS PERMIT Please note: Prior to completing this application form, refer to Appendix 1 of this form to ensure the correct application is being made. PART A SITE DETAILS Part B of this document

More information

merchant application form

merchant application form merchant application form standard & Point Of Sale (POS) Version 3.1 revised 28 February 2011 copyright mhits Limited 2004-2011 ABN 82 107 753 613 Instructions: 1. Fill in the Application Form 2. Sign

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

SIMPLY FINANCE PRIVACY AND CREDIT REPORTING POLICY

SIMPLY FINANCE PRIVACY AND CREDIT REPORTING POLICY SIMPLY FINANCE PRIVACY AND CREDIT REPORTING POLICY 1. Our privacy commitment Lane Financial Solutions Pty Ltd (ACN 146 182 256) (Australian Credit Licence No: 390275) trading as Simply Finance (Simply

More information

Real Property List Application Guide Victorian Civil and Administrative Tribunal Rules 2008 Rule 4.03 Form 2 Application for Order

Real Property List Application Guide Victorian Civil and Administrative Tribunal Rules 2008 Rule 4.03 Form 2 Application for Order Civil Division Application Guide Victorian Civil and Administrative Tribunal Rules 2008 Rule 4.03 Form 2 Application for Order The exists to resolve matters related to real estate. These include disputes

More information

Home and Contents Insurance Claim. and. corporate. Title Surname Full given name(s) Postcode Contact home phone number. Contact facsimile number ( )

Home and Contents Insurance Claim. and. corporate. Title Surname Full given name(s) Postcode Contact home phone number. Contact facsimile number ( ) BankSA Home and Contents Insurance Claim About this form Only About complete this form this form if your claim is in respect to loss of or damage to Buildings/Contents/Personal Valuables or Legal Liability.

More information

Application for Consultant Accreditation for Land Development Work

Application for Consultant Accreditation for Land Development Work Application for Consultant Accreditation for Land Development Work Do you need to complete this form? If you are a consulting engineering company and wish to seek accreditation with Barwon Water for Land

More information