Registered
ABN: 81 098 497 517
TP(June/16)
(Sep 14) Page 1 of 3
RA
RA
TP
Transfer of Agent
Authorised
Fishing Permits
Nomination
This
form should
allows be
you
to nominate
another
person
act as
This form
completed
when
a permit
holdertowants
to
your Agent. transfer their permit to another party.
permanently
As part of this nomination the Agent will:
Fees may apply for this service. Please refer to the schedule of fees
•
Be on
registered
aswebsite
an AFMA
GoFish Client or contact AFMA
listed
the AFMA
www.afma.gov.au
• Receive
from AFMA electronically
licensing
on notifications
1300 723 621.
Note: All your concessions are covered by this nomination
What you need to do
If you wish to nominate more than one Agent please
1) The current permit holder(s) and the proposed permit holder(s)
complete
a separate
RA and
form
for each
must complete
this form
make
sure itAgent
is signed and dated by
both
parties.
If you are not completing this form electronically please
complete the form in black or blue ink.
2) Post or fax this completed form along with the attachment(s) to:
Australian Fisheries Management Authority
Box 7051
Canberra
Business details
Centre ACT 2610
Concession
holder(s)
Fax: (02) 6225 5440
AFMA Client ID
Who
can of
sign
this form?
Name(s)
current
concession holder(s)
Companies – Where the company has a sole director who is also
the sole Company Secretary, this form must be signed and dated
by that person. If the company (pursuant to section 204A of the
Corporations
Act 2001) does not have a Company Secretary, a Sole
Agent details
Director can sign and date alone.
Agent
Name (complete
as: first
middle
initial,
surname)
If
the company
has more than
one name,
Director,
this form
must
be signed
and dated by two Directors or by one Director and the Company
Secretary.
AFMAholders
Client ID
for registered
clients)
Joint
– If(complete
the concession
is in moreAFMA
than one
name
(partnership or otherwise), all holders must sign and date this form.
If there are more than two holders, please attach a separate sheet.
Power
of Attorney
or Authorities
– To sign
under
a Power of
Only complete
below
if your nominated
Agent
is not
Attorney or Authority you must produce an original certified copy of
registered with AFMA
the Power of Attorney or Authority to this form.
Email address
Warning
Both parties should note that the transfer of a fishing permit will not
Date of birth
transfer any corresponding eligibility for statutory fishing rights to be
granted under Management Plans for any fishery. AFMA can be
/
/
contacted on 1300 723 621 for further information about eligibility
under
Postal fisheries
address management plans.
Privacy information
The Australian Fisheries Management Authority (AFMA) is
Postcode
authorised to collect the information provided
on this form under the
Fisheries
Management
Act
1991.
The
information
provided
Street address (if same as postal address, write ‘As
above’)will be
used for assessing your eligibility for a Commonwealth fishing
entitlement.
AgentAtype
PART
– Current permit holder’s details
You can select varying levels of agency for your
Name(s) of current permit holder(s)
nominated Agent depending on what you would like
Note: A business name is not necessarily a legal entity.
them to do on your behalf. All Agents will be authorised
A business name is either owned by a person, or persons,
to conduct
manual and electronic transactions on your
of a company.
behalf.
1
Multiple nominations are permitted for an Agent.
Please select the nomination type(s) for the proposed
Agent.
2
ABN number
(if applicable)
Agent
Postal address
3Logbook
Yes
No
A Logbook Agent may submit paper and electronic catch
data on your behalf.
Logbook Agents cannot access your concession
Postcode
information.
4
Street address (if same as postal address, write ‘As above’)
Is this Agent a skipper?
Licensing Agent
5
Yes
Postcode
Yes
No
No
Contact person’s name
A Licensing Agent may administer licensing tasks on
your behalf; including boat nominations and leases and
Business
phone to your concession.
enquiries
relevant
Mobile
This
type of Agent cannot undertake permanent transfers
unless
they have been specifically authorised to do so.
Fax
Email address
Primary Agent
Yes
No
A Primary Agent is able to nominate additional Licensing
Agents and Logbook Agents through GoFish. A Primary
Agent is also able to act as a Logbook and Licensing Agent.
This type of Agent cannot undertake permanent transfers
unless they have been specifically authorised to do so.
Consistent with AFMA’s objectives and/or functions and/or powers,
the information provided may be disclosed to:
• Australian, State and Territory governments(s) and agencies
Postcode
involved in the enforcement of law
• Australian and International fisheries research and management
Business
phone and
organisations,
• foreign governments in support of domestic and international
Mobile
obligations in relation to fisheries management,research and
compliance.
Fax
For more information about privacy please contact AFMA on
1300 723 621.
AFMA Direct 1300 723 621
Permanent transfer function Yes
No
The permanent transfer function allows an Agent to
permanently transfer assets on your behalf.
To nominate an Agent for the permanent transfer function,
the Agent must also be registered as a Primary or
Licensing Agent.
www.afma.gov.au
Protecting our fishing future
Registered
ABN: 81 098 497 517
TP(June/16)
(Sep 14) Page 2
1 of 3
RA
RA
TP
Transfer of Agent
Authorised
Fishing Permits
Nomination
This form should be completed when a permit holder wants to
permanently transfer
their permit to another
party. / Primary
Declaration
by Concession
holder(s)
PART A – Current permit holder’s details
Declaration by Agent
Agent
Fees may apply for this service. Please refer to the schedule of fees
of current permit holder(s)
1It isName(s)
an offence under s.136.1(1) of the Criminal Code Act 1995 to
listed on the AFMA website www.afma.gov.au or contact AFMA
licensing
onform
1300you
723must
621.be the concession holder(s) or
To sign this
their registered Primary Agent. Note Primary Agents cannot
What you need to do
authorise other Primary Agents or the permanent transfer
1) The current permit holder(s) and the proposed permit holder(s)
function. It is an offence under s.136.1(1) of the Criminal Code
must complete this form and make sure it is signed and dated by
Actboth
1995parties.
to make a false or misleading statement or omission.
I, the concession holder detailed in this form:
2)
thisthe
completed
form along
withform
the attachment(s)
• Post
Applyortofax
have
person specified
in this
appointed to to:
Australian Fisheries Management Authority
act on my behalf for the purposes as specified, and
Box 7051
• Acknowledge
that Business
I will be bound
all acts
or omissions of
Canberra
CentrebyACT
2610
this Agent
so
appointed
until
written
notice
of
revocation of the
Fax: (02) 6225 5440
Agent’s authority is received by AFMA, and
• Agree
the this
terms
and conditions for use of AFMA electronic
Who
canto
sign
form?
services,
and
Companies – Where the company has a sole director who is also
• Declare
that the Secretary,
informationthis
provided
on this
form is,and
to the
the
sole Company
form must
be signed
dated
by best
that person.
If the company
(pursuant
of my knowledge,
true and
correct.to section 204A of the
Corporations Act 2001) does not have a Company Secretary, a Sole
Signature
Director
can sign and date alone.
/
/
and
If
thedate
company has more than one Director, this form must be signed
and dated by two Directors or by one Director and the Company
Secretary.
Full Name
Joint holders – If the concession is in more than one name
(partnership
all (if
holders
must sign and date this form.
Position heldorinotherwise),
the company
applicable)
If there are more than two holders, please attach a separate sheet.
Power of Attorney or Authorities – To sign under a Power of
Attorney or Authority you must produce an original certified copy of
the Power of Attorney or Authority to this form.
Warning
Signature
/
/
and date
Both
parties should note that the transfer of a fishing permit will not
transfer any corresponding eligibility for statutory fishing rights to be
granted under Management Plans for any fishery. AFMA can be
Full Nameon 1300 723 621 for further information about eligibility
contacted
under fisheries management plans.
Position held in the company (if applicable)
Privacy information
The Australian Fisheries Management Authority (AFMA) is
authorised to collect the information provided on this form under the
Fisheries Management Act 1991. The information provided will be
used for assessing your eligibility for a Commonwealth fishing
Signature
entitlement.
/
/
and date
Consistent with AFMA’s objectives and/or functions and/or powers,
the information provided may be disclosed to:
•FullAustralian,
Name State and Territory governments(s) and agencies
involved in the enforcement of law
•Position
Australian
International
research and management
held and
in the
company (iffisheries
applicable)
organisations, and
Note:
A business
name statement
is not necessarily
a legal entity.
make
a false
or misleading
or omission.
A business name is either owned by a person, or persons,
of appointed
a company.
I, the
Agent detailed in this form:
• Apply to be registered to act for and on behalf of the
concession holder for the purposes as specified in this form,
and
• Acknowledge that I may be liable personally under the Act or
to the Principal for unlawful actions as an Agent, and
• Agree to transact electronically with AFMA, in accordance
ABN number
2 with
AFMA’s requirements, and to receive formal notices
(if applicable)
electronically from AFMA, as allowed for under the Electronic
Postal address
3 Transactions
Act 1999.
• Agree to the terms and conditions for use of AFMA electronic
services as detailed overleaf, and
• Declare that the information I have provided on this form is, to
the best of my knowledge, true and correct.
Postcode
Street address (if same as postal address, write ‘As above’)
4Signature
/
and date
/
Full Name
Postcode
5
Contact person’s name
Notes on completing this form
Business phone
ThisMobile
form should be used to nominate an Agent to do specific
things on behalf of the concession holder (or all joint concession
Fax
holders).
address
ThisEmail
authority
is acknowledged to bind the concession holder as
principal and each co-owner jointly and severally for the acts and
omissions of the authorised Agent appointed.
What you need to do
1. All joint concession holders should sign and date this authority.
2. Post, fax or email this completed form along with
attachment(s) to:
Australian Fisheries Management Authority
Box 7051
Canberra Business Centre ACT 2610
Fax: (02) 6225 5426
Email: [email protected]
• foreign governments in support of domestic and international
obligations in relation to fisheries management,research and
compliance.
If there is insufficient space for all signatories please attach a
For more information about privacy please contact AFMA on
separate sheet.
1300 723 621.
AFMA Direct 1300 723 621
www.afma.gov.au
Protecting our fishing future
Registered
ABN: 81 098 497 517
TP(June/16)
(Sep 14) Page 3
1 of 3
RA
RA
TP
Transfer of Agent
Authorised
Fishing Permits
Nomination
Who
can
signbethis
form?
This form
should
completed
when a permit holder wants to
permanently transfer their permit to another party.
Trading Name – All individuals for corporate owners of a trading
Fees
for thisas
service.
Please refer
tosign
the this
schedule
name may
mustapply
be specified
the applicants
and all
form. of fees
listed on the AFMA website www.afma.gov.au or contact AFMA
licensing on–1300
723 621.
Companies
A company
may sign in any manner (including under
seal) authorised by s127 of the Corporations Act 2001. If a company
What
youthan
need
do
has
more
onetoDirector
this form may be signed and dated by
1)
currentIfpermit
holder(s)
andone
the Director,
proposed
permit
holder(s)
twoThe
Directors.
a company
has only
that
Director
may
must complete this form and make sure it is signed and dated by
sign and date this form. In each case the Director should print their
both parties.
name and note their designation as ‘Director’, ‘Sole Director’ or ‘Sole
Director and Secretary’ as the case may be.
2) Post or fax this completed form along with the attachment(s) to:
Australian
Fisheries Management
Joint holders
– If the concession
is in more thanAuthority
one name
Box 7051
(partnership or otherwise), all holders must sign and date this form.
Canberra Business Centre ACT 2610
Please attach a separate sheet if the number of holders exceeds the
Fax: (02) 6225 5440
Inaccuracies and disputes – If you believe any transaction is wrong
PART
A – Current permit holder’s details
or unauthorised, you must immediately notify us. We may ask you
further
information.
will investigate any complaint
Name(s)
of current
permitWe
holder(s)
1to provide
about
disputed
information.
unable to settle
your
complaint
Note:
A business
nameIfiswe
notare
necessarily
a legal
entity.
immediately,
to your
our satisfaction,
will advise
you of the
A business
nameand
is either
owned by we
a person,
or persons,
of a company.
procedures
for further investigation and resolution and may request
further relevant details from you. It is recommended that you record
all receipt numbers, payment or transfer reference numbers as issued
to you to assist in checking inaccuracies and resolving disputes.
Our liability – To the extent permitted by law, we, our Agents or
nominated service providers will not be liable to you for any loss
consequential damage, arising as a result of: (i) your failure
ABN number
2including
to properly
protect your password; (ii) any breakdown or interruption
(if applicable)
in the AFMA electronic systems; (iii) any inaccuracy, corruption of
3
Postal address
data, errors or omissions resulting from a failure by you to properly
space available.
Who
sign thisorform?
Powercan
of Attorney
Authorities – If a party signs under a Power of
Attorney
the attorney
must
‘Signed
of principal)
his/
Companies
– Where
the state
company
hasbya(name
sole director
who by
is also
the sole Company
this form
must be
and
dated
her/their/its
attorney Secretary,
(name of attorney)
pursuant
tosigned
Power of
Attorney
by that person.
the company
to section
204A of
Register
NumberIf(number
or date(pursuant
if not required
to registered
in the
that
Corporations
Act 2001) does not have a Company Secretary, a Sole
State) who states that he/she has no notice of the revocation of the
Director can sign and date alone.
power’. A copy of the registered power should accompany this form.
If the company has more than one Director, this form must be signed
and dated
bybeneficial
two Directors
or by
Director
andbethe
Company
Trusts
– The
interests
in one
any trust
will not
recognised
by
Secretary.
AFMA (see s47 FM Act 1991). A trustee may only sign and date this
form
the legal– owner
in their own right.
Jointasholders
If the concession
is in more than one name
(partnership or otherwise), all holders must sign and date this form.
Terms
and
conditions
for please
use ofattach
AFMA
If there are
more
than two holders,
a separate sheet.
electronic
services
Power of Attorney or Authorities – To sign under a Power of
Attorney
or Authority
you
must
produce
original certified
copy of
Client
Service
Charter
– This
form
will bean
processed
in accordance
protect your password; (iv) any inaccuracy, corruption of data, errors
or omissions caused by the operation (or failure) of your ancillary
equipment; (v) the use of your password by another person; (vi) any
termination of your access to AFMA electronic Postcode
services.
Miscellaneous – You are responsible for ensuring that your contact
4
Street address (if same as postal address, write ‘As above’)
details are kept up to date. This Agreement with you and the
transactions carried out under it are governed by and construed in
accordance with the law for the time being in force in the Australian
Capital Territory and the parties submit to the jurisdiction of the
Postcode us to give
courts of the Australian Capital Territory. You authorise
information about you to others in order to execute your instructions
Contact
person’s
namethink it necessary.
5to us
where we
reasonably
Changes to terms and conditions – We may change these terms
the
Attorney
or Authority
to this form.
withPower
AFMA’sofClient
Service
Charter, available
on the AFMA website
andBusiness
conditionsphone
from time to time or may vary services provided to
www.afma.gov.au. This is subject to you supplying AFMA with
Warning
We Mobile
are not obliged to give you advance notice if an immediate
Both parties should note that the transfer of a fishing permit will not
Notices
fromcorresponding
AFMA – You agree
to transact
electronically
with us,
transfer any
eligibility
for statutory
fishing rights
to be
in
accordance
with
AFMA’s
requirements,
and
to
receive
formal
granted under Management Plans for any fishery. AFMA can be
contacted
on 1300 723
about
eligibility
notices
electronically
from621
us,for
as further
allowedinformation
for under the
Electronic
under
fisheries
management
plans.
Transactions Act (1999). “Notice” means any form of written
change
Fax to the terms and conditions is deemed necessary for the
everything needed to complete the transaction.
communication between you and us.
you. We will notify you of any change to the terms and conditions.
security of AFMA electronic services or individual accounts.
Email address
Privacy information – the Australian Fisheries Management
Authority (AFMA) is authorised to collect the information provided on
this form under the Fisheries Management Act 1991. Information is
Privacy information
collected pursuant to our data collection functions under the Fisheries
The Australian Fisheries Management Authority (AFMA) is
to restrict your access to AFMA electronic services for any reason.
authorised to collect the information provided on this form under the
You
may cancel
your useAct
at any
timeThe
by contacting
We will
maybe
Fisheries
Management
1991.
informationAFMA.
provided
terminate
your use atyour
any eligibility
time for any
without priorfishing
notice,
used for assessing
for reason
a Commonwealth
entitlement.
including for: security reasons; or if in our opinion you have breached
Administration Act 1991 (s7).
Restrictions and termination of access – We reserve the right
these
terms with
and conditions.
Consistent
AFMA’s objectives and/or functions and/or powers,
the
information
provided
may
be change
disclosed
to:password on first
Maintaining
security
– You
must
your
•use.
Australian,
State
andthe
Territory
governments(s)
and agencies
“Password”
means
6-14 digit
alphanumeric combination
that
involved in the enforcement of law
enables you to use AFMA electronic services. You must not disclose
•your
Australian
and International fisheries research and management
password to any other person. If you suspect or believe that
organisations, and
another person knows your password, you must report the matter
• foreign governments in support of domestic and international
to us. You will be liable for all transactions carried out by any other
obligations in relation to fisheries management,research and
person
who uses your password to access AFMA electronic services.
compliance.
You must take reasonable steps to ensure the security of your
Consistent with AFMA’s objectives and/or functions and /or
powers, the information provided may be disclosed to:
• Australian, State and Territory governments and agencies involved
in the enforcement of law
• Australian and International fisheries research and management
organisations
• foreign governments in support of domestic and international
obligations in relation to fisheries management, research and
compliance
More information about privacy and the disclosure of information can
be found in AFMA’s Information Disclosure policy available on the
AFMA website www.afma.gov.au.
For more information about privacy please contact AFMA on
ancillary equipment.
1300 723 621.
AFMA Direct 1300 723 621
www.afma.gov.au
Protecting our fishing future