Fillable Application for a Licence - INDIVIDUAL (Innovation and Science Australia)

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Application for a Licence - INDIVIDUAL (Innovation and Science Australia)

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Page 1 of 5
July 2020
ABN 81 913 830 179
Conveyancers Licensing Act 2003
Application for a Licence - INDIVIDUAL
FEE:
For information on fees click here
.
Before c
ompleting this application, please read the accompanying
Licence Application Guidelines.
How to lodge this document
8 Online
www.onegov.nsw.gov.au
and receive a discount
Service NSW Service Centre
For the location of your nearest Service NSW Service Centre,
go to www.service.nsw.gov.au or telephone 13 77 88.
For any enquiries regarding this application contact Fair Trading: Tel: (02) 9619 8799
TTY: (02) 9619 8673
Fair Trading will aim to make a decision on this application within 6 weeks after receiving all relevant
information from the applicant and other agencies.
1. APPLICANT DETAILS
Surname:
Select the licence duration you are applying for:
_________________________ Given Names: ___________________________________________________
Other names you are, or have been known by, including maiden name: __________________________________
____________________________________________________________________________________________
Date of Birth: ___________________ Place of Birth:
Residential Address: __________________________________________________________________________
____________________________________________________________ Postcode: ______________________
Email Address to which correspondence, including renewal applications, will be sent:
________________________________________________@__________________________________________
Postal Address - Correspondence will be sent to this address if an email address is not provided:
_____________________________________________________________ Postcode: _____________________
Driver’s Licence No: __________________________ Mobile Telephone No: ________________________________
2. PREVIOUS LICENCE HELD
Have you previously held a conveyancer’s licence in New South Wales? YES
o NO o
If yes, p
lease provide licence number: _________________________________
OFFICE USE ONLY
Application No.
1 Year
3 Years
5 Years
Page 2 of 4
3. IDENTIFICATION
Y
o
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a
t
t
a
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t
o
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is application legible evidence of your identity such as a copy of your driver licence, photo card,
passport, birth certificate or change of name certificate.
4. BUSINESS ADDRESS
If a licensee is conducting a conveyancing business for fee or reward, the business must be conducted from an
address located within New South Wales.
Street address at which you intend to be employed or conduct your own conveyancing business:
___________________________________________________________________________________
__________________________________________________________ Postcode: _______________
Telephone Number: ___________________________ Mobile Number: ________________________
5. BUSINESS NAME
If you own the conveyancing business that will be carried on at the above-specified address and that
business will be carried on under a business name, you must attach to this application a copy of a
document issued by the Australian Securities and Investments Commission that confirms you are the
business name holder.
A business name will only be added to your licence record if this document has been provided.
6. PARTNERSHIP AND / OR SHARING OF RECEIPTS DETAILS
A licensee must not be in partnership or share receipts with another person unless:
• the other person is a licensee, or
• the partnership and/ or sharing of receipts with that other person is approved by the Commissioner
and does not contravene the provisions of the Conveyancers Licensing Act 2003 or regulation.
If you intend to perform conveyancing work in partnership with another person whether the person is
licensed or not, or if you intend to share receipts with an unlicensed
person, you must complete the
Partnership / Sharing of Receipts Application / Notification which is also alavailable on the Fair
Trading website.
7. QUALIFICATIONS
The approved qualifications, training and experience required for the grant of a conveyancer’s licence is set out in
the Conveyancers Licensing Order 2006. More information about the qualifications is contained in the
accompanying “Licence Application Guidelines”.
You must provide with this application evidence of your qualifications AND a letter from your supervising
conveyancer(s) and / or supervising solicitor(s) stating:
• the nature of the conveyancing duties that you have undertaken while under their supervision;
• the number of hours per week that you received supervised practical training and experience; and
• the number of weeks / months / years that you received supervised practical training and experience.
Note: You do not have to provide this information if you are applying under mutual recognition legislation.
8. PROFESSIONAL INDEMNITY INSURANCE
The Conveyancers Licensing Regulation 2015 requires a conveyancer licensee, when carrying out
conveyancing work, to be insured under an approved policy of professional indemnity insurance in force
with respect to the licensee or his or her employer. It is a condition of a licence that the holder of the
licence be insured as required.
Refer to the accompanying “Licence Application Guidelines” for information on what is an approved
policy of professional indemnity insurance.
Page 3 of 4
9. DISCLOSURE QUESTIONS
The disclosure questions are to be completed by the applicant in respect of each person nominated
o
n
t
h
i
s
a
p
p
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i
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a
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form, e.g. applicant, licensee-in-charge and partners.
1
Have you been convicted in NSW or elsewhere of ANY offence that was
recorded In the last 10 years?
YES
NO
2
Are you, or have you been in the preceding 3 years an undischarged
bankrupt?
YES
NO
3
At any time in the preceding 3 years, did you apply to take the benefit of
any law for the relief of bankrupt or insolvent debtors?
YES
NO
4
At any time in the preceding 3 years, did you compound with your creditors
or make an assignment of your remuneration for their benefit?
YES
NO
5
Are you a director or person concerned in the management of ANY
externally-administered body corporate?
YES
NO
6
At any time in the preceding 3 years were you a director or person
concerned in the management of ANY externally-administered body
corporate?
YES
NO
7
At any time in the preceding 3 years were you a director or person
concerned in the management of ANY body corporate that, within 12
months of you ceasing to be such a director or person, became an
externally-administered body corporate?
YES
NO
8
Are you disqualified from holding a licence, certificate, registration or other
authority in NSW or elsewhere?
YES
NO
9
Have you had a licence, certificate, registration or other authority cancelled
in NSW or elsewhere for disciplinary reasons?
YES
NO
10
Do you hold a licence, certificate, registration or other authority in NSW or
elsewhere that is suspended?
YES
NO
11
Have you been declared to be a disqualified person as a result of
disciplinary action?
YES
NO
12
Do you owe a monetary penalty payable as a result of disciplinary action in
respect of being or having been a licensed conveyancer?
YES
NO
13
Do you owe an amount due as a debt to the Crown by way of an amount
paid out of the Property Services Compensation Fund?
YES
NO
14
Have you failed to comply with a direction given by the Commissioner
under the Act?
YES
NO
15
Have you been removed (otherwise than at your own request) from the roll
of lawyers kept by the Supreme Court or from a corresponding roll of
lawyers kept by a superior court of another State or Territory?
YES
NO
16
Are you disqualified from being employed in a law practice by virtue of an
order made under Division 1 of Part 3.9 of the Legal Profession Uniform
Law (NSW)
?
YES
NO
17
Are you an Australian legal practitioner?
YES
NO
18
Are you a disqualified person under the Property, Stock and Business
Agents Act 2002
?
YES
NO
19
Are you the holder of a licence or certificate of registration under the
Property, Stock and Business Agents Act 2002
?
YES
NO
Page 4 of 4
10. DECLARATION BY APPLICANT
I apply for the grant of a licence under the Conveyancers Licensing Act 2003 and certify that:
1. I have read the document accompanying this application titled “Licence Application Guidelines”;
2. the particulars specified in this application and all attachments are, to the best of my knowledge, true and
correct in every detail; and
3. I undertake to be insured under an approved policy of professional indemnity insurance as required by clause
6 of the Conveyancers Licensing Regulation 2015 when carrying out conveyancing work.
Statement under the Privacy and Personal Information Protection Act 1998.
The applicant for this licence:
1. authorises NSW Fair Trading to make any inquiries and to receive and disclose any information which is
relevant to the applicant's initial and ongoing eligibility to hold this licence;
2. acknowledges that information will be placed on a register open to the public in accordance with the
Conveyancers Licensing Act 2003;
3. accepts that failure to supply information required on this application form may delay the processing of
the application and;
4. has a right to seek access to and correction of information supplied.
NOTE: It is an offence under the Crimes Act 1900 to make a false or misleading statement in this
document. The maximum penalty is imprisonment for two years or a fine of $22,000 or both.
Signature: Date:
Full Name:
Note: It is an offence for a person to conduct a conveyancing business for fee or reward if the person is not the holder of
a conveyancer’s licence.
How to lodge this document
Online
www.onegov.nsw.gov.au
and receive a discount
Service NSW Service Centre
For the location of your nearest Service NSW Service
Centre, go to www.service.nsw.gov.au or telephone 13
77 88.
Fair Trading will aim to make a decision on this application within 6 weeks after all relevant information has been
received from you and other agencies.
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Application for a Licence - INDIVIDUAL (Innovation and Science Australia)

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Completed 2 August 2021

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