Boat Licence Application - Department of Primary Industries

ABN: 78 342 684 030
This form may be used for the issue of:
1) Commercial Fishing Boat Licence
2) Carrier Boat Licence
Boat Licence Application
Fisheries Act 1994
Office Use Only
CN:___________________
LN:___________________
Applicant details (Please print in block letters or complete on screen)
Family name or company name
Given name/s
Postal address (This can be a Post Office Box address. This address will be available on the DPI&F Register)
Postcode
Residential/Registered office address (Not a Post Office Box address, this address will not be released under a search of the
Register unless it is also your postal address)
Postcode
Home number
Work number
Fax number
Mobile number
Email address
Licence/Boat details
Type of licence (please tick): Commercial Fishing Boat
Carrier Boat ► Please attach description of intended carrying activities.
Boat details
Boat mark Boat name Length (m) Beam (m) Depth (m)
Year built Home port Hull material Colour Gross Tonnage (t)
Main engine details
Make Model Brake KW Year made
Carrier boat only
Product carried
Live/ fresh/ frozen
Applicant declaration
I/We apply for a licence as indicated above.
Other licences held in respect of this boat: Licence type Licence number
(e.g. Torres Strait Licence, etc)
I enclose the application fee of $
Signature
Date
Debit details: American Express Bankcard MasterCard Visa card
Card number Expiry date Debit amount
Name on card
Signature
Application continued over page…
Form FDU1457 V01/06 © State of Queensland 2006 Forms Management Unit

Boat Licence Application continued…page 2 of 2
Note: All named authority holders must sign. For a corporation, the form is signed in accordance with the Corporations Act 2001,
s127 by either two directors, or a director and a company secretary, or (for a proprietary company) the sole director who is
the sole secretary.
Forward application to: Fisheries, Department of Primary Industries and Fisheries, GPO Box 2764, Brisbane QLD
4001For information, contact: (07) 3225 1868 or fax (07) 3229 8182
Privacy Disclaimer: Information you provide to the Department on this form is made available to the public in the Register of Authorities under
Section 73 of the Fisheries Act 1994 and Section 210 of the Fisheries Regulation 2008. You must therefore provide a postal address in the
knowledge that it may be released under a search. You must also provide for an individual, a residential address, or for a corporation, a registered
office address for the purpose of giving notices under fisheries legislation. The residential/ registered office address will not be made available
under a search of the Register unless it is also the postal address. It is mandatory to provide an address in both sections.
Notes:
Company extract
If the licence is to be held by a registered company, a copy of the current company extract issued by the Australian Securities and
Investment Commission should be provided. You may provide a copy with your application, or alternatively the copy can be
arranged on your behalf by contacting this office (fees apply).
Native title
This application may be subject to notification under the Native Title Act 1993 in which case additional information may be required,
and some delays may be experienced.
Warning against increasing fishing effort
It is the responsibility of the transferee to ascertain whether the fishing authority being transferred may be used for the purposes
intended and to seek advice on any current investment warnings or management arrangements, existing or proposed, that
could affect the use of the fishery authority. More information on investment warnings is available from the Fisheries Licensing Unit
or online at http://www.dpi.qld.gov.au/fishweb/
Form FDU1457 V01/06 © State of Queensland 2006 Forms Management Unit