Approved form AF2002-31

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 -
Renewal

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

PROMOTING CONSUMER CONFIDENCE
ABN 98 636 852 025

APPLICATION FOR A SECOND-HAND DEALERS LICENCE
INDIVIDUAL
RENEWAL
Warning: Please read the application carefully. Providing false or misleading information is an offence and will result in disqualification.

OFT.SHD.IND.LIC.REN.01

SHD.

Licence Number

Office use only
Registration Fee:

Paid by:	Cash

Cheque

Receipt Number:

Police check Fee: (only if applicable)

Registration Officer:

TOTAL PAYABLE:

Licence RENEWED date:

Licence EXPIRY date:

/	/

$

$

$

*	I

*	I

*	I

HAVE / HAVE NOT (cross out whichever does not apply) committed an offence against the Second-hand Dealers Act 1906 or a corresponding law of a State or foreign country.
HAVE / HAVE NOT (cross out whichever does not apply) 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.
HAVE / HAVE NOT (cross out whichever does not apply) committed, in Australia or a foreign country, an offence involving fraud or dishonesty.

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

I hereby apply to renew my 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
In the past 12 months:

Please read the notes under "Applications" on the back of this form

Signature of Applicant	Date of Application

 
/	/

/	/

Office use only
APPROVAL
Renewal 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.REN.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 renewal 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 renewal must accompany the application.

If, in the past 12 months, you have committed an offence of the type referred to in your Declaration on the front of this form, your application must also be accompanied by a "Consent to Obtain Personal Information" form. That form 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 renewal of your second-hand dealers licence.

Your licence will not be renewed until the Commissioner of Fair Trading, or a delegate of the Commissioner, has approved your application. The Commissioner must be satisfied that you are still 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 (only if applicable)	$ 36.00 (Includes $3.27 GST)

LODGEMENT
Applications for renewal of 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