Security Providers Act 1993 • Form - • V • July Page of
Part 1—Licence type applied for
Licence type
Please note the licence fees
usually change on July each
year.
Note: a restricted licence is
for carrying out the functions
of the security provider
selected under direct
supervision of an unrestricted
licensee who holds the same
licence functions. A restricted
licence is issued for a term
of six months only. After the
term ends, you cannot apply
for a further restricted licence
for carrying out any of the
functions authorised under
the first restricted licence.
You must complete training
requirements and apply for
an unrestricted licence before
the restricted licence expires
in order to continuously
perform the functions of a
security provider.
Licence function
Note: Unrestricted licence
applicants must meet the
qualification requirements
for each licence function
selected and, in the case
of a security officer, each
category selected.
Single function
RESTRICTED licence (see note below)
six month $182.20
Multiple functions
RESTRICTED licence (see note below)
six month $219.90
(please select one function from the list below)
UNRESTRICTED licence
(please select two or more functions from the list below)
UNRESTRICTED licence
one year $320.60 three years $634.80 one year $395.90 three years $798.10
(please select one function from the list below)
Bodyguard
Crowd controller
Private investigator
Security officer—you must select one or more
of the following categories:
Security officer—unarmed
Security officer—cash in transit
Security officer—dog patrol
Security officer—monitoring
(please select two or more functions from the list below)
Bodyguard
Crowd controller
Private investigator
Security officer—you must select one or more of
the following categories:
Security officer—unarmed
Security officer—cash in transit
Security officer—dog patrol
Security officer—monitoring
The above fees do not include the criminal history check fee of $39.35
(inclusive of $. GST) or the
fingerprinting fee of $..
I also enclose:
Mandatory criminal history check fee of $.
Mandatory fingerprinting fee of $.
Part 2—Applicant details
Section 1
Applicant details
Preferred title: Mr Mrs Ms Miss Other (specify) ...............................
Surname ..........................................................................................................................................
Given names ....................................................................................................................................
Have you been known by any other name? Yes
No
Previous names ................................................................................................................................
Reason for change ...........................................................................................................................
Section 2
Date and place of birth
Note: This office will only
accept photocopies of
documents certified by the
following people: Justice of
the Peace, Commissioner
for Declarations, barrister/
solicitor or Notary Public.
Refer to Part 4—Personal
identification 100 point check
If you are lodging this application in person, you must provide points of identification from the
checklist in Part , 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.
The photocopy must contain the original signature of the person certifying the identification.
Date of birth
Place of birth: Town ..................................................................................................... State
Country
.......................................................................................................................
Australian driver’s licence number ............................................................State of issue
Passport number ........................................... ImmiCard number ...................................................
Passport country .............................................................................................................................
Passport type:
Government Private UN refugee
Eligibility to work in Australia
Are you an Australian citizen? Yes
No
If you are not an Australian citizen supply a certified copy of your international passport.