Department of State Growth Road User Services Division Form Number: MR97 03/18 Application for Temporary Upgrade Permit Registered Operator Mobile No. Address Vehicle registration Vehicle Make End Date of permit Start date of permit Modification number/s (Check page 2 of this form, for requirements) Signature Date Permits are available for periods of 1-90 days, providing registration does not expire within this period. A vehicle must have a GCM recorded prior to issue of the permit. Manufacture or Modification Plate number must be provided where indicated on matrix. It is the registered operators responsibility to provide correct details and ensure appropriate manufacturers ratings on all equipment. It is an offence to tow a trailer where the combination laden mass of the truck and trailer exceed the GCM of the it truck and is the operator’s responsibility to ensure that the permit vehicle has a GCM within the range of the upgraded configuration. Requested Classification Current Classification (place in ) 1R2 or 2R2 SR2 SP2 SR3 MR3 SP3 1R3 or 2R3 1R4 or 2R4 SR4 MR4 SP4 Prime Mover for B Double MC2 MC3 MC4
Department of State Growth Road User Services Division Form Number: MR97 03/18 Application for Temporary Upgrade Permit Registered Operator Address Mobile No. Vehicle registration Vehicle Make Start date of permit End Date of permit Modification number/s (Check page 2 of this form, for requirements) Signature Date Permits are available for periods of 1-90 days, providing registration does not expire within this period. A vehicle must have a GCM recorded prior to issue of the permit. Manufacture or Modification Plate number must be provided where indicated on matrix. It is the registered operators responsibility to provide correct details and ensure appropriate manufacturers ratings on all equipment. It is an offence to tow a trailer where the combination laden mass of the truck and trailer exceed the GCM of the truck and it is the operator’s responsibility to ensure that the permit vehicle has a GCM within the range of the upgraded configuration. Current Classification Requested Classification (place in ) 1R2 or 2R2 SR2 SP2 1R3 or 2R3 SR3 MR3 SP3 1R4 or 2R4 SR4 MR4 SP4 Prime Mover for B Double MC2 MC3 MC4
MR97_06_16_Temporary_Upgrade_Permit.docx