This form should be completed to apply for a Torres Strait
Fish Receivers Licence.
Fees may apply for this service. Please refer to Schedule 1
of the Torres Strait Fisheries Regulations 1985 for details.
What you need to do
Note: If you need more space for any of your answers,
please attach a separate sheet with the details.
PART A – Applicants details
1 Name(s) of Applicant(s)
2 ACN (if applicable)
3 ABN (if applicable)
4 Postal address
5 Street address
6 Contact person’s name
Business phone
Mobile
Fax
Email
FR-TS (September 17) Page 1 of 2
FR-TS
Application for a Torres Strait
Fish Receivers Licence
AFMA Direct 1300 723 621 www.afma.gov.au Protecting our fishing future
Post, fax or email this completed form along with any
attachments to:
Australian Fisheries Management Authority
Box 7051
Canberra Business Centre ACT 2610
Fax: (02) 6225 5440
licensing@afma.gov.au
Who can sign this form?
Trading NameAll individual or corporate owners of a
trading name must be specied as applicants and all sign
this form.
CompaniesA company may sign in any manner (including
under seal) authorised by s127 of the Corporations Act
2001.
Co-Holders – if the concession is in more than one name
(partnership or otherwise), all holders must sign this form.
If there are more than two holders please attach and date
a separate sheet.
Powers of Attorney – If a party signs under a Power
of Attorney the attorney must state ‘Signed for (name of
principal) by his/her/its attorney (name of attorney) pursuant
to the Power of Attorney Register number (number or date
if not required to be registered in that State) who states
that he/she has no notice of the revocation of the power’. A
copy of the registered power should accompany this form.
TrustsA Trustee may only sign and date this form as the
legal owner in their own right
PART B – Details of premises
7 Address of the main premises where the sh will be
received
Type of premise : Fish packer Fish farm
Processing plant Wholesaler Other
If Other Specify
8 Address(es) of additional premises where the sh will
be received
a)
Type of premise : Fish packer Fish farm
Processing plant Wholesaler Other
If Other Specify
b)
Type of premise : Fish packer Fish farm
Processing plant Wholesaler Other
If Other Specify
c)
Type of premise : Fish packer Fish farm
Processing plant Wholesaler Other
If Other Specify
PART C – Declaration by applicant
IMPORTANT
Please read the ‘Who can sign this form’ on
Page 1 before completing this declaration
It is an offence under s136.1(1) of the Criminal
Code Act 1995 to make a false or misleading
statement or omission.
I, the applicant detailed in Part A of this form:
Apply for a Torres Strait Fish Receivers Licence
for the premises named in Part B, and
Declare that the information provided on this form
is, to the best of my knowledge, true and correct.
Signature and date
Full name
Position held in company (if applicable)
Signature and date
Full name
Position held in company (if applicable)
Company seal (if applicable)
/ /
/ /
FR-TS
FR-TS (September 17) Page 2 of 2
Application for a Torres Strait
Fish Receivers Licence
AFMA Direct 1300 723 621 www.afma.gov.au Protecting our fishing future
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