Must details of the technical standards used in the design and/or the engineering principals used in the design and declaration that have complied with the designer’s obligations under ‘I Section 22 of the Work Health and Safety (National Uniform Legislation) Act in respect to the design of the plant,’ dated and signed. The statement must be in English or translated into English. Document outlining engineering principals used (if applicable). Certified copies of qualifications of the design verifier. Certificate of business registration (if applicant conducts the business or undertaking under a business name). Privacy statement The Department of Attorney-General and Justice complies with the Information Privacy Principles scheduled to the Information Act. Lodgement Territory Business Centre – Completed applications can be lodged in person, email or via post at a Territory Business Centre below: Darwin Katherine Tennant Alice Springs Darwin Corporate Park Shop 1, Randazzo Shop 2, Barkly House Ground Floor, The Green Well Building. Building. Building 3 Cnr Davidson and 18 Katherine Terrace. Patterson Street. 50 Bath Street 631 Stuart Highway, Berrimah Phone number: 1800 Email address: 193 111 Postal address: GPO Box 9800, Darwin, NT 0801 Payment details Cash Cheque Credit card Note: cheques must be made out to Receiver of Territory Money (RTM). Name on credit card: Credit card Expiry: number: I hereby authorise the Territory Business Centre to debit the above credit card for the $ amount of Signature of cardholder: Date:
Must details of the technical standards used in the design and/or the engineering principals used in the design and declaration that ‘I have complied with the designer’s obligations under Section 22 of the Work Health and Safety (National Uniform Legislation) Act in respect to the design of the plant,’ dated and signed. The statement must be in English or translated into English. Document outlining engineering principals used (if applicable). Certified copies of qualifications of the design verifier. Certificate of business registration (if applicant conducts the business or undertaking under a business name). Privacy statement The Department of Attorney-General and Justice complies with the Information Privacy Principles scheduled to the Information Act. Lodgement – Territory Business Centre Completed applications can be lodged in person, email or via post at a Territory Business Centre below: Darwin Darwin Corporate Park Building 3 631 Stuart Highway, Berrimah Katherine Shop 1, Randazzo Building. 18 Katherine Terrace. Tennant Shop 2, Barkly House Cnr Davidson and Patterson Street. Alice Springs Ground Floor, The Green Well Building. 50 Bath Street Phone number: 1800 193 111 Email address: Postal address: GPO Box 9800, Darwin, NT 0801 Payment details Cash Cheque Credit card Note: cheques must be made out to Receiver of Territory Money (RTM). Name on credit card: Credit card number: Expiry: I hereby authorise the Territory Business Centre to debit the above credit card for the amount of $ Signature of cardholder: Date: