Commercial and Private Agents Licensing Act Please in block letters. If there is insufficient space, attach extra sheets. All questions must be answered and full particulars provided. Once this application form is complete it must be lodged at a Territory Business Centre with the prescribed fee. For any enquiries relating to this application please contact (08) 8999 1800 Application for Approval for an Agents Manager 1. Licence Details Licensee name Licence number Expiry date Licence category held: Commercial Agent Private Bailiff Inquiry Agent Process Server Business address 2. Applicant details Title Mr Mrs Ms Miss Surname Given name(s) Date of birth Street address Postal address Telephone Facsimile Mobile Email 3. Declaration by employer This section is to be completed and signed by the authorised nominee of the licensee where the applicant is to be employed. I, (insert name of authorised nominee)
Commercial and Private Agents Licensing Act Please in block letters. If there is insufficient space, attach extra sheets. All questions must be answered and full particulars provided. Once this application form is complete it must be lodged at a Territory Business Centre with the prescribed fee. For any enquiries relating to this application please contact (08) 8999 1800 Application for Approval for an Agents Manager 1. Licence Details Licensee name Licence number Expiry date Licence category held: Commercial Agent Private Bailiff Inquiry Agent Process Server Business address 2. Applicant details Title Mr Mrs Ms Miss Surname Given name(s) Date of birth Street address Postal address Telephone Facsimile Mobile Email 3. Declaration by employer This section is to be completed and signed by the authorised nominee of the licensee where the applicant is to be employed. I, (insert name of authorised nominee)
application-for-approval-for-an-agents-manager-form.docx