Darwin Katherine Darwin Corporate Park Shop 1, Randazzo Building Ground Building 3 18 Katherine Terrace 631 Stuart Highway Katherine Berrimah PO Box 9800 GPO Box 9800 Katherine NT 0851 Darwin NT 0801 t: (08) 8973 8180 t: (08) 8982 1700 f: (08) 8973 8188 f: (08) 8982 1725 e: Toll free: 1800 193 111 e: Tennant Creek Alice Springs Shop 2, Barkley House Ground Floor, The Green Well Building Cnr Davidson and Paterson Street 50 Bath Street Tennant Creek Alice Springs PO Box 9800 PO Box 9800 Tennant Creek NT 0861 Alice Springs NT 0871 t: (08) 8962 4411 t: (08) 8951 8524 f: (08) 8982 1725 f: (08) 8951 8533 e: e: Contact your Territory Business Centre for the relevant schedule of fees. EFT Please contact Licensing NT to arrange for a Tax Invoice to be raised. Authorisation for payment by Credit Card. Bankcard Visa MasterCard Credit card number Expiry Name on card I hereby authorise the Territory Business Centre to the above credit card for $ the amount of Amount in words dollars Signature of cardholder Date Contact phone number
Darwin Darwin Corporate Park Ground Building 3 631 Stuart Highway Berrimah GPO Box 9800 Darwin NT 0801 t: (08) 8982 1700 f: (08) 8982 1725 Toll free: 1800 193 111 e: Katherine Shop 1, Randazzo Building 18 Katherine Terrace Katherine PO Box 9800 Katherine NT 0851 t: (08) 8973 8180 f: (08) 8973 8188 e: Tennant Creek Shop 2, Barkley House Cnr Davidson and Paterson Street Tennant Creek PO Box 9800 Tennant Creek NT 0861 t: (08) 8962 4411 f: (08) 8982 1725 e: Alice Springs Ground Floor, The Green Well Building 50 Bath Street Alice Springs PO Box 9800 Alice Springs NT 0871 t: (08) 8951 8524 f: (08) 8951 8533 e: Contact your Territory Business Centre for the relevant schedule of fees. EFT Please contact Licensing NT to arrange for a Tax Invoice to be raised. Authorisation for payment by Credit Card. Bankcard Visa MasterCard Credit card number Expiry Name on card I hereby authorise the Territory Business Centre to the above credit card for the amount of $ Amount in words dollars Signature of cardholder Date Contact phone number