Approved form AF2002-29

approved by the Commissioner of Fair Trading on 12 March 2002 under the

Second-hand Dealers Act 1906, s18 (Approved Forms)

Second-hand Dealers Act 1906
(see s 3)

Australian Capital Territory

Application for a Second-hand Dealers Licence – Individual

(See attached form entitled Application for a Second-hand Dealers Licence – Individual)

PROMOTING CONSUMER CONFIDENCE
ABN 98 636 852 025

APPLICATION FOR A SECOND-HAND DEALERS LICENCE
INDIVIDUAL

Warning: Please read the application carefully. Providing false or misleading information is an offence and will result in disqualification.

OFT.SHD.IND.LIC.01

Office use only
SHD.

Licence Number

Office use only
Registration Fee:

Paid by:	Cash

Cheque

Receipt Number:

Police check Fee:

Registration Officer:

TOTAL PAYABLE:

Licence ISSUED date:

Licence EXPIRY date:

/	/

$

$

$

To the Commissioner of Fair Trading, Level 2, GIO House, City Walk, Canberra City (GPO Box 158, Canberra City ACT 2601)

I hereby apply for a Second-hand Dealers Licence in the A.C.T.	My details are:
PERSONAL  DETAILS
Surname or Family Name	Christian names or Given names

Date of birth

 
/	/

Other names used (include past names, aliases and maiden names)

Telephone number

Facsimile number

RESIDENTIAL  ADDRESS

Mobile phone number

Number and Street

Email address

Postcode

State / Territory

City,  Suburb or Town

POSTAL ADDRESS	(if different to Residential Address above)
PO Box or Number and Street	City, Suburb or Town

State / Territory

Postcode

TRADING NAME(S)	Enter all trading names, whether or not registered as business names. Continue overleaf if insufficient space.

PLACE(S) OF BUSINESS IN A.C.T.Include all places of business in the A.C.T.	Continue overleaf if insufficient space.

DECLARATION
*	I am 18 years old or older.
*	I have not committed an offence against the Second-hand Dealers Act 1906 or a corresponding law of a State or foreign country.
*	I have not been refused a second-hand dealers licence, or had a licence cancelled or revoked, under the Second-hand Dealers Act 1906 or a corresponding law of a State.
*	I have not committed, in Australia or a foreign country, an offence involving fraud or dishonesty.

Date of Application

Signature of Applicant

 
/	/

/	/

Office use only
APPROVAL
Issue of Second-hand Dealers Licence is

Reason for refusal:

APPROVED   /  REFUSED

Signature of Commissioner of Fair Trading or Delegate	Date of approval

	
	
/	/	

OFT.SHD.IND.LIC.02

ADDITIONAL TRADING NAME(S)	(Enter all trading names, whether or not registered as business names)

ADDITIONAL  PLACE(S) OF BUSINESS	(Include all places of business in the A.C.T.)

APPLICATIONS

An application for the issue of a Second-hand Dealers Licence must be in the approved form. This document is the approved form for the purposes of applications under the Second-hand Dealers Act 1906. The relevant fee  for your licence must accompany the application.

Your application must also be accompanied by a "Consent to Obtain Personal Information" form which enables the Australian Federal Police to provide relevant information about you, if any, from the records of the Australian Federal Police and/or the Police Services of all or any of the States and Territories of the Commonwealth of Australia. You must provide a copy of your driver's licence or some other form of official photographic identity (to assist you, we will make a copy of your original document of identity for this purpose).  You must pay a fee for  this police records check at the time of lodging your application for the second-hand dealers licence.

A licence will not be issued to you until the police records check has been returned to us and the Commissioner of Fair Trading, or a delegate of the Commissioner, has approved your application. The Commissioner must be satisfied that you are a "suitable person" within the meaning of the Second-hand Dealers Act 1906, before approving your application.

FEES
The following fees are payable at the time of application, either by cash or cheque:

Application for a Second-hand Dealers Licence	$ 92.00 (Exempt GST)
Fee for a Police Records Check	$ 36.00 (Includes $3.27 GST)

LODGEMENT
Applications for a Second-hand Dealers Licence may be lodged with:
Manager
Registration & Client Services Unit Office of Fair Trading
Level 2   GIO House
City Walk  Canberra City   ACT  2601

Or by post to:
Manager
Registration & Client Services Unit Office of Fair Trading
GPO Box 158
Canberra City   ACT  2601