Fee $114
GST Exempt
01/07/16 - 30/06/17
Processing time:
5 business days
SOUTHERN ZONE ROCK LOBSTER FISHERY
Fisheries Management Act 2007
Fisheries Management (Rock Lobster Fisheries) Regulations 2006
APPLICATION TO VARY A BOAT REGISTRATION
With this completed application:
(Please tick when complete)


Enclosed application payment of $114
Enclosed a copy of current certificate of operation
All applications must be completed in full before being lodged with PIRSA Fisheries &
Aquaculture. Applications that are not complete, or that do not have correct documentation
attached, will be returned. Please contact PIRSA Fisheries & Aquaculture on (08) 8204 1370 if
you have any queries. Licence Holder MUST initial each page (bottom right corner).
PART 1 – APPLICANT DETAILS
Licence number: ...........................................................................................................
Name of Licence holder: ...............................................................................................
PLEASE NOTE: Boats endorsed on a Rock Lobster licence must not be endorsed on
any other Rock Lobster Licence.
PART 2 – BOAT(S) to be REMOVED
Boat 1
Boat Name: .................................................
Boat 2
Boat Name: ..................................................
Length: .........................................................
Length ...........................................................
Survey No: ....................................................
Survey No: ....................................................
If you are removing a boat from your Southern Zone Rock Lobster fishery licence, have
you removed all Rock Lobster Pots from the water?
YES
NO
Rock Lobster Pots will need to be removed from the water before we can proceed with
the application
PIRSA FISHERIES & AQUACULTURE
Level 14, 25 Grenfell Street, Adelaide SA 5000
GPO Box 1625, Adelaide SA 5001
Telephone (08) 8204 1370 Facsimile (08) 8204 1388
Email [email protected]
http://www.pir.sa.gov.au/fisheries/home
Licence Holder Initials
FISHERIES & AQUACULTURE - Updated July 2016
Page 1 of 3
PART 3 – BOAT(S) to be ADDED
Boat 1
Boat Name: .................................................
Boat 2
Boat Name: ..................................................
Main Colour: ................................................
Main Colour: .................................................
Length: ............................................... metres
Length: ............................................... metres
Home Port: ...................................................
Home Port: ....................................................
Construction Material: ..................................
Construction Material: ...................................
Survey No: ...................................................
Survey No: ...................................................
Does this vessel comply with Survey and Certificate of Operation requirements?
Boat 1 - Yes / No
Boat 2 - Yes / No
Please provide a copy of the certificate of operation if available.
PLEASE NOTE: As the owner (and or master) of a vessel it is your responsibility to ensure that the
vessel is fit for commercial fishing operations. If you are unsure please contact the Department of
Planning, Transport and Infrastructure (DPTI):
DEPARTMENT OF PLANNING, TRANSPORT AND
INFRASTRUCTURE
Service SA Building
13 Kateena Street, Regency Park. SA 5010
PO Box 2526, Adelaide SA 5942
Telephone 1300 885 793 Facsimile (08) 8115 5536
Email: [email protected]
Is the boat registered by endorsement on any other South Australian fishery
licence?
Boat 1 - Yes / No
Boat 2 - Yes / No
Licence No: .................................................
Licence No: .................................................
PART 4 – VICTORIAN ROCK LOBSTER COMMERCIAL LICENCE
Pursuant to regulation 25 of the Fisheries Management (Rock Lobster Fisheries) Regulations
2006, a person who is the holder of a licence in respect of the Southern Zone Rock Lobster
Fishery must inform the Minister, in writing within 14 days if he or she becomes the holder, or
ceases to be the holder of a Victorian commercial fishing licence.
Do you have an interest in a Victorian Rock Lobster commercial fishery licence?
YES
NO
Licence Holder Initials
FISHERIES & AQUACULTURE - Updated July 2016
Page 2 of 3
PART 5 – DECLARATION
I declare this boat complies with the requirements under the Harbours and Navigation
Act 1993.
I .............................................................................
(Natural Person/ Director)
(Full name of person completing this form – individual licence holder or company Director)
of (address) .................................................................................................................
Contact Telephone Number: .....................................
who is the holder of Fishery Licence No:. ..................................................................................
hereby certify that this application is to the best of my knowledge and belief true and
accurate. I know that this information is to be used for the purpose of the administration
of the Fisheries Management Act 2007 and if it is false or misleading in a material
particular (whether by reason of inclusion or omission of any particular) I may be guilty
of an offence.
Dated the ................ of ............................................................ ,
20 ..........................
Signed: ...................................................................
Witnessed by: ..........................................................
(Full Name)
of ............................................................................
(address)
Signature of Witness: ................................................
Licence Holder Initials
FISHERIES & AQUACULTURE - Updated July 2016
Page 3 of 3