2014 ENVIRONMENTAL MANAGEMENT CHARGE (EMC)
CHARGE RETURN
Payment: q BPAY
q Direct Debit
q Cheque
q JAN-MAR q APR-JUN q JUL-SEP q OCT-DEC
q Credit Card (purchasing surcharge applies)
Permittee ................................................................................................................... Permit number.....................................................
Authorised contact for EMC .......................................................Phone ............................................ Fax ...........................................
Trading name .............................................................................................................................................................................................
EMC quarters
Due date
1 January to 31 March
30 April
1 April to 30 June
31 July
1 July to 30 September
31 October
1 October to 31 December
31 January
You are legally required to meet all your E
. MC obligations such as maintaining appropriate records and providing information
and .payments by the due dates. Penalties apply if obligations are not met. For more information refer to the 2014 Great
Barrier Reef Marine Park Environmental Management Charge Guide.
PLEASE ATTACH THE RELEVANT PAGES FROM THE LOGBOOK TO THIS RETURN
D E CL A RA T I O N
Please read and sign this declaration after filling in your charge return.
Where the permit has been granted to more than one person, this charge return must be signed by all permittees, or an
authorised contact for this permit.
Where the permittee is a company, this charge return must be signed in the name of the company by a person who is
authorised by the company, and that person’s name and position must also be appended.
I declare that the information given is true and correct; and
I declare that the information recorded in the logbook sheets enclosed with this charge return is true and correct; and
Where the permittee is a company, I declare that I am duly authorised by the company to sign this charge return on its behalf.
I acknowledge that it is an offence to give false or misleading information,
Signature....................................................... Date........................Signature....................................................... Date.........................
Name (Print).................................................................................... Name (Print) ....................................................................................
Position............................................................................................Position.............................................................................................
NOTE: If you need space for more signatures please attach additional pages.
CHECKLIST:
q
Has the declaration been signed?
qHave all visitor and passenger numbers been recorded on the logbook sheets?
qHave you completed a charge return summary form (if applicable)?
qHave you remitted the EMC collected to the agency?
VISITORS (PAX) FOR WHOM EMC IS PAYABLE
PAYMENT OP TIONS
FULL DAY
You may make an EMC payment by BPAY, cheque, credit card or direct
deposit. Please ensure that your payment clearly identifies your Reference
Number.
Calculate the amount owing for visitors for whom the full day charge is payable:
Total Full day pax ............................... X $3.50 =
$
BPAY – PART DAY
Calculate the amount owing for visitors for whom the part day EMC is payable:
Total Part day pax ............................... X $1.75 =
$
Direct deposit – Bank details for the GBRMPA may be obtained by contacting the EMC unit on (07) 4750 0700 or by email at
[email protected]
STAND ALONE GLASS-BOTTOMED BOAT/ STAND ALONE
SEMI-SUBMERSIBLE
Calculate the amount owing for visitors for whom the stand alone glass-bottomed
boat or stand alone semi-submersible EMC is payable:
$
Total GGB*/SS* daily charge pax ............................... X $0.40 =
OTHER PROGRAMS DAILY CHARGE
Calculate the amount owing for visitors for whom the non-tourist charge is payable:
$
Total other programs daily charge pax ............................. X $2.00 =
T O T A L E M C P AY A B LE
Full day + Part day + GGB*/SS* + Non-tourist daily charge =
To pay EMC using BPAY refer to your Reference Number and Biller Code on the front of this logbook.
Cheques – Please make cheques payable to the Great Barrier Reef Marine Park Authority and address them to:
Great Barrier Reef Marine Park Authority
Reply Paid 1379
TOWNSVILLE QLD 4810
Credit card – To pay by credit card contact the GBRMPA on
(07) 4750 0700. Please note that any bank charges incurred from credit institutions for processing transactions will be added to the final payment amount.
$
If you did not operate in the Great Barrier Reef Marine Park for this quarter,
please write ‘Nil Activity’ on the charge return.
Full PartNon-tourist GBB* Prev. >3 Transfer
dayday charge SS* FOC paiddays No.
Total
A
Total
B
Total
C
TOTAL
* GBB Stand alone glass bottom boat, SS stand alone semi-submersible
To update your details, please email [email protected]
or phone (07) 4750 0700.