New licence application Form 1–2 Notes
ABN: 13 846 673 994
Application for a corporation’s licence
Real estate agent, property auctioneer, resident letting agent,
motor dealer, chattel auctioneer, field agent
Property Occupations Act 2014
Motor Dealers and Chattel Auctioneers Act 2014
Debt Collectors (Field Agents and Collection Agents) Act 2014
This form is eective from 1 July 2019
19_1160FT
Who can use this form?
New licence application form 1-2 is for corporations to apply for real estate agent, auctioneer (real property), and resident letting
agent licences under the Property Occupations Act 2014, motor dealer and chattel auctioneer licences under the Motor Dealer and
Chattel Auctioneers Act 2014, and field agent licences (for collection of debts) under the Debt Collectors (Field Agents and Collection
Agents) Act 2014. If you require an individual licence, please use the New licence application form 1-1.
Fees payable
The Acts provide for a licence applicant to pay both an application fee and a licence issue fee. These fees are in the Property
Occupations Regulation 2014 and the Motor Dealers and Chattel Auctioneers Regulation 2014, and the Debt Collectors (Field Agents
and Collection Agents) Act 2014. Listed below are the current application and licence issue fees for a single licence category of one or
three years. Applicants for a single class licence, for either one or three years must pay the listed fee.
Licence category One year term
(One licence category –
includes non-refundable
application fee of $169.60)
Three year term
(One licence category –
includes non-refundable
application fee of $169.60)
Real estate agent, auctioneer (real property), resident letting
agent, motor dealer, chattel auctioneer and field agent
$829.40 $1495.60
Corporations applying for more than one class of licence under the Property Occupations Act 2014,or the Motor Dealers and Chattel
Auctioneers Act 2014, or the Debt Collectors (Field Agents and Collection Agents) Act 2014 only pay the licence fee shown above.
Criminal history check
A criminal history check (CHC) will be conducted for each person whose name is listed on the application. The fee for each CHC
conducted is $39.35 (inclusive of $1.13 GST) and processing of the application cannot be progressed until this fee is paid. Criminal
history checks are conducted in accordance with the legislation as outlined in the Property Occupations Act 2014 and Motor Dealers
and Chattel Auctioneers Act 2014. history checks are conducted in accordance with the legislation as outlined in the Property
Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014, and Debt Collectors (Field Agents and Collection Agents) Act
2014. All applications are subject to mandatory criminal history checks. CHC fees are not included in the above fees.
Please note: A CHC is not required if one has been completed under a relevant Act within the past six months. If it is outside of this
timeframe then another one is required.
*Relevant Act includes:
Motor Dealers and Chattel Auctioneers Act 2014,
Property Occupations Act 2014,
Debt Collectors (Field Agents and Collection Agents) Act 2014,
The repealed Property Agents and Motor Dealers Act 2000.
Total fee = 1 or 3 year fee $ ................................. + CHC $ ..................................... ($39.35 x no. required) = $ .......................................
Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014 and
Debt Collectors (Field Agents and Collection Agents) Act 2014 • Form 12 Notes • V8 • July 2019 Page 1 of 11
Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014 and
Debt Collectors (Field Agents and Collection Agents) Act 2014 • Form 12 Notes • V8 • July 2019 Page 2 of 11
Part 1—Licence details
Property occupations
The following licence classes allow the licensee to perform
the activities listed below as an agent for others for reward.
Real estate agent
buy, sell, exchange or let real property or interests in real
property
buy, sell, exchange or let businesses or interests in
businesses
negotiate for the buying, selling, exchanging or letting of
real property or interests in real property
negotiate for the buying, selling, exchanging or letting of
businesses or interests in businesses
collect rents.
Auctioneer (real property)
sell or attempt to sell or offer for sale or resale any real
property or interest in real property by way of auction
sell real property by any means during the auction period
sell or attempt to sell or offer for sale or resale goods by
auction if they are directly connected with the auction of
a real property holding.
Resident letting agent
let lots in a building complex
collect rents for lots in a building complex.
Limited real estate agent (business letting)
buy, sell, exchange or let businesses or interests in
business
negotiate for the buying, selling, exchanging, letting of
businesses or interests in businesses
collect rents for commercial premises.
Motor dealer and chattel auctioneer occupations
The following licence classes allow the licensee to perform
the activities listed below for reward.
Motor dealer
acquire used motor vehicles primarily for resale
sell used motor vehicles
sell used motor vehicles on consignment
sell leased motor vehicles to the lessee under the terms
of the lease
acquire used motor vehicles, whether or not as complete
units, to break up for sale as parts
sell used motor vehicles as parts
negotiate, under a consultancy arrangement, for a
person who is not a motor dealer or a chattel auctioneer
for the purchase or sale of a used motor vehicle for the
person.
Motor dealer (broker)
negotiate for the purchase or sale of a used motor
vehicle for another person who is not a motor dealer or
auctioneer under a consultancy arrangement.
Motor dealer (wrecker)
acquire used motor vehicles, whether or not as complete
units, to break up for sale as parts
sell used motor vehicles as parts.
Chattel auctioneer
sell goods by auction
sell goods by any means during the auction period.
Debt Collectors (Field Agents and Collection Agents)
occupations
A field agent licence allows the licence holder to perform the
activities listed below for reward.
Find or repossess goods for a person, or any goods or
chattels that the person is entitled to repossess under an
agreement
Collect or request debt payments
Serve a writ, claim, summons application or other process.
A field agent licence is not required where the activity is
performed without face-to-face communication with the
debtor.
Part 3—Previous licences
If the corporation held an equivalent licence under the
current Property Occupations Act 2014, the Motor Dealers
and Chattel Auctioneers Act 2014, the Debt Collectors (Field
Agents and Collection Agents) Act 2014 or the repealed
Property Agents and Motor Dealers Act 2000 which expired
less than two years ago, list the licence details in Part 3.
Part 4—Trading particulars
Indicate the corporation’s method of trade and complete the
appropriate parts of the form.
Corporationyou intend to operate your business through
the corporation under its own name, or any business name
of which it is proprietor. You are required to nominate a
person in charge who holds the same licence in Queensland.
Each executive officer is required to complete the executive
officer page, supply identification, and undergo a criminal
history check.
Partnershipyou intend to operate your business through
the corporation in partnership with other individuals or
corporations. Each executive officer of the applicant
corporation, and all individual partners, are required to
complete the executive officer page, supply identification,
and undergo a criminal history check. Individual partners who
perform licensable activities (see Part 1), and any corporation
partners, are required to hold the appropriate licence in
Queensland. A corporation cannot be a silent partner.
Part 5—Places of business
Principal place of business—the place where the licence
holder performs the licensable activity and where records
of this activity are kept is considered the principal place of
business. There must be a suitably licensed person in charge
of the principal place of business, except for field agents
who require a licensed person in charge of the regulated
business. A post office box is not acceptable as a place of
business.
Other place of business—places of business divided by
a public road are considered separate, and each must
nominate a different licensed person in charge. If more
than two places of business are operated, an attachment
must be provided listing all places of business operated,
any business names used at each place, and the name and
licence number of the licensed person in charge at each
place of business.
Places of business must be within Australia, and are not
restricted to Queensland. Real estate agents may nominate
a real estate salesperson to be person in charge of a place of
business other than the principal place.
Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014 and
Debt Collectors (Field Agents and Collection Agents) Act 2014 • Form 12 Notes • V8 • July 2019 Page 3 of 11
Resident letting agents are not required to supply body
corporate approval as part of the application, however, it
is a requirement of the licence to hold and maintain current
body corporate approval to manage each building complex.
Resident letting agents must have an office in the building
that is the registered office. A person cannot be in charge
of more than one building unless the buildings are not
separated by a public road. Resident letting agents may
nominate a resident letting agent or a real estate agent to be
person in charge.
Business name
The licence holder must be the proprietor of any business
name used in conjunction with a licence issued by the
Office of Fair Trading. If a trust is listed as a proprietor of
the business name, acceptable evidence must be provided
that the licence holder is entitled to operate on behalf of the
trustees e.g. a photocopy of the relevant page from the trust
deed listing the trustees of the trust.
Part 6—Partnership details
This section is to be completed if Partnership was selected
in Part 4. If there is insufficient space to include all partners,
please attach additional pages.
List the names of all partners, corporation and individual
in this section. All corporations in a partnership must be
licensed. If a partner is an individual, Part 7 must also be
completed for each individual partner.
Part 7—Executive officer and individual
business associate
This section requires the applicant or licensee to provide
details of all executive officers and/or business associates of
the corporate applicant, irrespective of whether each person
holds or is applying for a licence. Certified proof of identity
documents must be supplied for each person showing their
current name. If there is more than one executive officer or
business associate then this section must be printed and
completed for each person.
Part 8—Suitability checklist
This section of the form relates to the corporate applicant,
all executive officers of the corporate applicant and business
associates (partners).
A corporation is not a suitable person to hold a licence if the
corporation:
has been convicted in the past five years in Queensland
or elsewhere of a serious offence
is currently disqualified from holding a licence.
A corporation is also not a suitable person to hold a licence if
an executive officer of the corporation:
is insolvent under administration
has been convicted in the past five years in Queensland
or elsewhere of a serious offence
is currently disqualified from holding a licence or
registration certificate
is subject to a relevant control order (motor dealer licence
applicants only).
While an applicant is automatically deemed not suitable to
hold a licence if they answer yes to any of the above, there
are also a number of other matters which must be considered
when determining suitability. If you answer yes to any of the
suitability questions listed on the application form, please
provide the full details in writing.
Relevant Acts include the Motor Dealers and Chattel
Auctioneers Act 2014, the Property Occupations Act 2014, the
Debt Collectors (Field Agents and Collection Agents) Act 2014,
the repealed Property Agents and Motor Dealers Act 2000 or a
corresponding law.
‘insolvent under administration’ has the meaning as defined
in the Corporations Act 2001, section 9.
The Corporations Act 2001 defines insolvent under
administration as:
1. a person who, under the Bankruptcy Act 1966 or the law
of a foreign country has the status of an undischarged
bankrupt; or
2. a person who, under the law of an external Territory
or the law of a foreign country, has the status of an
undischarged bankrupt; or
3. A person whose property is subject to control under:
a. Section 50 or Division 2 of Part X of the Bankruptcy
Act 1966; or
b. A corresponding provision of the law of an external
Territory or the law of a foreign country; or
4. A person who has executed a personal insolvency
agreement under:
a. Part X of the Bankruptcy Act 1966; or
b. The corresponding provisions of the law of an
external Territory or the law of a foreign country;
Where the terms of the agreement have not been
fully complied with; or
5. A person who is a party (as a debtor) to a debt agreement
under:
a. Part IX of the Bankruptcy Act 1966; or
b. The corresponding provisions of the law of an
external Territory or the law of a foreign country.
serious offence’ means any of the following offences
punishable by three or more years imprisonment:
an offence involving fraud or dishonesty
an offence involving the trafficking of drugs
an offence involving the use or threatened use of violence
an offence of a sexual nature
• extortion
• arson
unlawful stalking.
For motor dealer applicants only, a serious offence also
includes:
an offence against the Criminal Code, section 76
(Recruiting person to become participant in criminal
organisation)
an offence mentioned in the Criminal Code, part 2,
chapter 9A (Consorting); or
an offence that is –
- a prescribed offence within the meaning of the
Penalties and Sentences Act 1992, section 161N; and
- committed with a serious organised crime
circumstance of aggravation within the meaning of
the Penalties and Sentences Act 1992, section 161Q
Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014 and
Debt Collectors (Field Agents and Collection Agents) Act 2014 • Form 12 Notes • V8 • July 2019 Page 4 of 11
The fact that a sentence for one of the offences was less than
three years does not lessen the applicant’s responsibility
for disclosure. If in doubt answer ‘Yes’ and provide written
details of the conviction. It is an offence to provide incorrect
or misleading information.
conviction’ includes a plea of guilty or a finding of guilt by
a court, but does not include a plea of guilty or a finding of
guilt by a court if no conviction is recorded by the court.
corresponding law’ means a law of another State, Territory
or New Zealand that provides for the same matter as a
relevant Act or a provision of a relevant Act.
If you are uncertain about any of the above, you can
contact the Office of Fair Trading on 13 QGOV (13 74 68) for
information and assistance.
Declaration
All persons relating to this application (including for
example: Directors, Executive Officers and Business
Associates) must be a suitable person. The applicant must
have the consensus of all these persons for a criminal
history check to be conducted for this application.
Please note: The criminal history check fee is payable for
each check conducted in relation to the application.
Lodgement details
Please ensure your application is fully completed and you
have attached proof of identification documents, fees and
attachments as required. If any details or fees are missing or
incomplete our office will be required to write to you which
delays the processing of your application and the issue of
your licence. If no response is received from you within a
reasonable timeframe, your application may be deemed to
have been withdrawn by you. In this circumstance a refund
of fees paid less the application fee and criminal history
check fees (if the checks have been conducted) will be
refunded to you. You will then need to resubmit another
application if you still require the licence.
Licence approval
Normal processing time for new applications is 4–6 weeks
however this can be longer if we need to contact you for
missing information or fees. Applications can sometimes be
delayed awaiting clearance of police checks which is outside
the control of the Office of Fair Trading. If your application is
refused we will send an information notice to you explaining
your rights and the process involved in appealing the
decision.
The corporation is not able to perform the functions of a
licensee until a licence has been issued.
Refunds
You can withdraw your application at any time prior to
the licence being granted or refused. If the application is
withdrawn by you or deemed withdrawn or refused you
will receive a refund of the fees paid less a non-refundable
application processing fee and any fees paid for criminal
history checks that have already been conducted.
This section has been intentionally left blank.
New licence application Form 1–2 (COR)
ABN: 13 846 673 994
Application for a corporation’s licence
Real estate agent, property auctioneer, resident letting agent,
motor dealer, chattel auctioneer, field agent
Property Occupations Act 2014
Motor Dealers and Chattel Auctioneers Act 2014
Debt Collectors (Field Agents and Collection Agents) Act 2014
This form is eective from 1 July 2019
Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014 and
Debt Collectors (Field Agents and Collection Agents) Act 2014 • Form 12 • V8 • July 2019 Page 5 of 11
Part 1—Licence details
Section 1
Corporation details
Name of corporation .....................................................................................................................
ACN
Section 2
Property occupations
Please tick appropriate box. See Notes accompanying this form for definitions of licence categories.
Real estate agent
Resident letting agent
Auctioneer (real property)
Limited real estate agent (affordable housing)
Limited real estate agent (business letting)
Section 3
Motor dealer and chattel
auctioneer occupations
Please tick appropriate box. See Notes accompanying this form for definitions of licence categories.
Motor dealer
Chattel auctioneer
Motor dealer (wrecker)
Motor dealer (broker)
Section 4
Debt Collector occupations
Please tick appropriate box. See Notes accompanying this form for definitions of licence categories.
Field agent
Section 5
Licence term
1 Year 3 Years
Instructions
Before completing this application, please read the accompanying Form 12 Notes.
Please complete application in BLOCK letters
Attach extra pages if necessary
References to dates should be in DD/MM/YYYY
Fees quoted in this application/notes may alter at any time by Regulation
Refer to notes for fees—No GST is payable on licence fees
Criminal history check fee of $39.35 (inclusive of $1.13 GST per check)
All executive officers of the corporation and individual business associates of the applicant, are
subject to mandatory criminal history checks. This fee is not included in the application fee and
must be included with your payment. Processing of your application will not be progressed until
this fee is paid.
Please note: A criminal history check is not required if one has been completed under a relevant
Act in the last six months.
Incomplete applications
Failure to complete this form or provide all the information, fees and documents will result in a
delay in granting your licence.
Privacy statement—please read
The Office of Fair Trading collects information, including personal information, on this form as
required by the Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014,
and the Debt Collectors (Field Agents and Collection Agents) Act 2014 to process your application.
In accordance with these Acts, some personal information may be passed on to police services
in Australia (including federal, states and territories) for criminal history searches. Enquiries may
also be made with the Department of Home Affairs to verify eligibility to work in Australia. Your
name and business address will be placed on a register which may be inspected by the public.
Additionally, information on this form can be disclosed without your consent where authorised or
required by law. Under the Fair Trading Act 1989 information may also be shared on a confidential
basis with other Australian fair trading agencies.
Change of details
If at any time your licence details or suitability requirements change, you must notify the
Office of Fair Trading in writing within 14 days.
OFFICE USE ONLY
Date received
.................................................
Payment details
Application allocation
$ .............................................
CHC fee $ ................................
Total allocation $ ....................
Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014 and
Debt Collectors (Field Agents and Collection Agents) Act 2014 • Form 12 • V8 • July 2019 Page 6 of 11
Part 2Contact details
Section 1
Contact details
Business phone ............................................................ After hours phone .....................................
Fax number .................................................................... Mobile .....................................................
Email address ...................................................................................................................................
Preferred contact method: B/H
A/H Mobile Email Mail
Section 2
Postal address
Address ...........................................................................................................................................
Suburb ......................................................................... State
Postcode
Change of address: If you change your address you are required to notify the chief executive in
writing within 14 days. You may be issued with a fine if you do not notify Industry Licensing within
the required timeframe.
Part 3—Previous licences
Section 1
Has the corporation held an equivalent licence under the current Property Occupations Act 2014,
the Motor Dealers and Chattel Auctions Act 2014, the Debt Collectors (Field Agents and Collection
Agents) Act 2014, or the repealed Property Agents and Motor Dealers Act 2000? If so, provide the
licence details below.
Licence number
Period: from: / / to: / /
Licence number
Period: from: / / to: / /
Office use only
Type Licence number Status Condition
Period
From To
Part 4Trading particulars
Trading particulars
See Notes accompanying this
form for information and tick
the option which is applicable
to you.
Corporation with no business partners (complete below question and Parts 5 & 7)
Corporation trading in partnership (complete below question and Parts 5, 6 & 7)
Does the corporation sub-contract its services to another licence holder?
Yes
No
When you have completed the above parts as required, complete this form from Part 8 onwards
This area has been intentionally left blank.
Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014 and
Debt Collectors (Field Agents and Collection Agents) Act 2014 • Form 12 • V8 • July 2019 Page 7 of 11
Part 5—Places of business
Section 1
Principal place of business
A post office box address is
not acceptable.
Registered National Business Name (if applicable)
.........................................................................................................................................................
Principal place of business ...............................................................................................................
Suburb ........................................................................... State
Postcode
Name of person in charge .................................................................................................................
Licence number of person in charge
Section 2
Other places of business
(if applicable)
A post office box address is
not acceptable.
A person cannot be in charge
at more than one place of
business.
Registered National Business Name (if applicable)
.........................................................................................................................................................
Other place of business ....................................................................................................................
Suburb ........................................................................... State
Postcode
Name of person in charge .................................................................................................................
Licence number of person in charge
Will you have more than two places of business? Yes No
If yes, you will need to supply an attachment with this form listing your other places of business,
the business name (if any) used at each place of business and the name and licence number of the
licensed person in charge at each place of business.
Part 6—Partnership details
Name of partners
If you have more than two
partners you will need to
supply an attachment with
this form listing all your
partners and their licence
numbers.
Part 7 of this form must be
completed for each individual
partner.
Partner 1 name ..................................................................................................................................
ACN (if partner is a corporation)
Partner licence number (if licensed)
Partner 2 name .................................................................................................................................
ACN (if partner is a corporation)
Partner licence number (if licensed)
All corporations in a partnership must be licensed.
This area has been intentionally left blank.
Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014 and
Debt Collectors (Field Agents and Collection Agents) Act 2014 • Form 12 • V8 • July 2019 Page 8 of 11
Part 7—Executive officer and individual business associate (partner) details
If there is more than one executive officer or individual business associate (partner) you will need to print and complete a copy of
this section for each person.
Section 1
Executive officer /
individual business
associate details
An individual business
associate is another
individual with whom the
licensee carries on business.
An executive officer is any
person concerned with or
takes part in the management
of a corporation (Directors
and company secretaries).
NOTE: Individuals
must provide certified
identification in their current
name.
*Only photocopies of
documents certified as being
a true copy of the original
document by a Justice of
the Peace, Commissioner
for Declarations, barrister/
solicitor, or Notary Public can
be accepted. The photocopy
must contain the original
signature of the person
certifying the identification.
Preferred title Mr
Mrs Ms Miss Other (specify) .................................
Surname ..........................................................................................................................................
Given names ....................................................................................................................................
Have you been known by any other name? Yes
No
Previous names ................................................................................................................................
If you are lodging this application in person, you can provide your original birth certificate/ extract,
passport, Australian certificate of citizenship or driver’s licence, which will be copied and certified
by the officer accepting your application. If you are lodging this application by mail, please send a
photocopy certified as being a true copy.*
Date of birth
/ /
Place of birth: Town ............................................................................................... State
Country ............................................................................................................................................
Section 2
Residential address
A post office box address is
not acceptable.
Home address ..................................................................................................................................
Suburb ......................................................................... State
Postcode
Section 3
Postal address
Enter ‘as above’ if the same
as residential address.
Address ...........................................................................................................................................
Suburb ......................................................................... State
Postcode
Section 4
Contact details
Business phone ............................................................ Home phone .............................................
Fax number .................................................................... Mobile .....................................................
Email address ...................................................................................................................................
Section 5
Any persons that perform any
activity in the business that
requires a licence must be
appropriately licensed.
Does this person perform any activity in the business which will require them to hold a real estate
agent, auctioneer, motor dealer, chattel auctioneer, resident letting agent, or field agent licence?
Yes—Licence number
No
This area has been intentionally left blank.
Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014 and
Debt Collectors (Field Agents and Collection Agents) Act 2014 • Form 12 • V8 • July 2019 Page 9 of 11
Part 8—Suitability checklist
Suitability requirements
Please see Notes
accompanying this form for
explanation.
It is an offence to supply
incorrect or misleading
information.
Disclosure of previous
convictions does not
automatically disqualify
you from holding a licence.
However, failure to disclose
convictions may result in
your licence being cancelled
and prosecution action being
commenced.
*Executive officer of
a corporation means
any person who is
concerned, or takes part,
in the management of the
corporation (director or
company secretary)
**Relevant Act includes:
Property Occupations Act
2014
Motor Dealers and Chattel
Auctioneers Act 2014
Debt Collectors (Field
Agents and Collection
Agents) Act 2014
the repealed Property
Agents and Motor Dealers
Act 2000
a corresponding law.
If you answer Yes to any of these questions, you need to provide full details in writing.
Has the corporation, any executive officers or any business associates listed in Parts 6 and 7:
Been found guilty of an offence (excluding traffic or misdemeanour offences)
in Queensland or elsewhere, within the last five years? Yes
No
Been convicted of an offence and/or disqualified from holding a licence or
registration certificate under a relevant Act** or the Agents Financial
Administration Act 2014? Yes
No
Received an adverse order under the Property Occupations Act 2014,
the Motor Dealers and Chattel Auctioneers Act 2014, the Debt Collectors
(Field Agents and Collection Agents) Act 2014, or the repealed
Property Agents and Motor Dealers Act 2000 from QCAT or the District
court in the last five years? Yes
No
Been (or are) insolvent under administration (this includes entering into
bankruptcy or a Personal Insolvency Agreement under Part X of the
Bankruptcy Act 1966 or is a party as a debtor to a debt agreement under
Part IX of the Bankruptcy Act 1966)? Yes
No
Been an executive officer* of a corporation licensed under a relevant Act**
that has been placed into receivership or liquidation? Yes
No
Been placed into receivership or liquidation? Yes No
Been named in the register of persons disqualified from managing
corporations under the Corporations Act? Yes
No
Ever had a licence or registration certificate refused, suspended or
cancelled under a relevant Act**? Yes
No
Had an amount paid from the Claim Fund including the Funds established
under the repealed Property Agents and Motor Dealers Act 2000 or the
repealed Auctioneers and Agents Act 1971, because of an action or omission
that gave rise to a claim? Yes
No
Relevant control order in
relation to a licence, means
a control order or registered
corresponding control order
that restricts the person
to whom the order applies
from carrying on a business,
engaging in an occupation or
performing an activity that
requires the licence.
Motor dealer licence applicants only
Control orders
The corporation is not a suitable person to hold a licence under the Motor Dealers and Chattel
Auctioneers Act 2014 if an executive officer is subject to a relevant control order as defined under
the Motor Dealers and Chattel Auctioneers Act 2014.
This area has been intentionally left blank.
Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014 and
Debt Collectors (Field Agents and Collection Agents) Act 2014 • Form 12 • V8 • July 2019 Page 10 of 11
Part 9Checklist and declaration
Applicant to sign
Must be signed by an
executive officer of the
Corporation.
Please check each statement and tick each box if you have met the following requirements:
I/We have made appropriate enquiries and to the best of my knowledge all details on this
application have been provided honestly and correctly
I/We have enclosed certified identification for each individual/partner and office holder/s
shown on this application
I have enclosed the application fee $ ...................................................................................and
Criminal history check of $39.35 x ........................................= $ ................................................
In submitting this application, I declare I have the consent of all persons relating to this application
being subject to a national criminal history check by the Queensland Police Service (QPS) and
for QPS and other Australian police services to disclose criminal history information and any
impending charges to the Office of Fair Trading.
I understand any disclosure will be subject to applicable Commonwealth, state or territory
legislation and/or police policy. Enquiries may also be made with the Department of Home
Affairs to verify eligibility to work in Australia. In other instances, information on this form can be
disclosed without your consent where authorised or required by law.
I declare the answers I have given on this form and attachments are true and correct in every detail.
I have read and agree to the terms stated above.
Applicant signature ..........................................................................................................................
Signatory’s name .............................................................................................................................
Position held ...................................................................................................................................
Date
/ /
Lodgement details
IMPORTANT!
Please make sure you:
provide all necessary
information and
documentation
sign the application
return all pages of the
application form.
Please lodge the completed application, any supporting documentation and applicable fees to
the Office of Fair Trading at the address below, at one of our regional offices, or at a Queensland
Government Service Office.
By mail:
Industry Licensing Unit, GPO Box 3111, Brisbane QLD 4001
In person:
Visit www.qld.gov.au/fairtrading or call 13 QGOV (13 74 68) for information and your nearest
Fair Trading Office or Queensland Government Service Office.
Refunds
If an applicant withdraws an application prior to a licence being issued, or it is refused, the
application fee and fees paid for criminal history checks that have already been conducted are not
refundable.
Change of details
If at any time your licence details or suitability requirements change, you must notify the
Office of Fair Trading within 14 days.
This area has been intentionally left blank.
Property Occupations Act 2014, Motor Dealers and Chattel Auctioneers Act 2014 and
Debt Collectors (Field Agents and Collection Agents) Act 2014 • Form 12 • V8 • July 2019 Page 11 of 11
Payer details
This section must be
completed if payment has
been made by another person
on behalf of the applicant.
Name ..............................................................................................................................................
Postal address ................................................................................................................................
Suburb ............................................................................State
Postcode
Mobile .......................................................................... Fax number .............................................
Receipt request Yes
No
Email ..............................................................................................................................................
Payment
Payment details
Cashpay in person
Do not send cash by mail
Debit/Credit card Money order Cheque
Make money order or cheque payable to the Office of Fair Trading.
A receipt will not be issued unless specifically requested.
Debit/Credit card
OFT cannot accept debit/credit card details over the phone, fax or email (including any attachments)
in accordance with the Payment Card Industry Data Security Standard. If an email or fax is received
containing debit/credit card details, it will be deleted immediately and your application and
payment will not be processed.
Charge my:
Go online to www.qld.gov.au/fairtrading
Debit/Credit card number:
Cardholders name: ........................................................................................................................................................
Amount authorised: $ .......................................................................................... Expiry date:
Cardholders signature: .......................................................................................................................................................
Online
payments
Tick box if you wish to pay online
If you select this option, once OFT has received your documentation, an officer will be in
contact to provide you with a Customer Reference Number (CRN). You can use this to pay via
the following methods:
Go online to www.qld.gov.au/fairtrading
Payments can be made using BPAY through your bank or financial institution using the
reference details that will be provided to you.
By post
A cheque or money order can be posted in, together with the application form.
Make money order or cheque payable to the Office of Fair Trading
In person
You can also visit a Fair Trading Office or an applicable Queensland Government Service Office to
lodge this application and pay the applicable fees over the counter.
Visit www.qld.gov.au/fairtrading or call 13 QGOV (13 74 68) for your nearest Fair Trading Office or
Queensland Government Service Office.
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome