Australian Capital Territory
Architects (Appointment of Nominees) Approval 2004
Approval Statement for
Approved Form AF2004-8
made under the 
Architects Act 2004, section 92 (Approved Forms)

1	Name of instrument
	This instrument is the Architects (Appointment of Nominees) Approval 2004.
2	Commencement 
	This instrument commences on the day after notification.
3	Approval
The attached form is approved for the purpose of appointing ACT registered architects as nominees in the Australian Capital Territory.

Cynthia Breheny
Chair
ACT Architects Board
24 June 2004

Privacy
Information

The information you are asked to provide will be used to assess your ability to hold registration as an Architect in the ACT. 

The lawful authority for the collection of this information is the Architects Act 2004. The information may be disclosed to other Architect Registration Authorities. 

Note

If a firm has only 1 nominee they become the Primary Nominee.

If a firm has more than 1 nominee and a director or partner is listed as 1 of those nominees they become the Primary Nominee.

If a firm has more than 1 nominee and more than 1 director or partner listed as nominees the firm must nominate 1 to become the Primary Nominee.

A2

Notification – Appointment of Nominees

Organisation Details

         Organisation name ___________________________________________________________
Partnership or Company __________________________ ACN _____________________________
              Postal Address  ___________________________________________________________
 	               ____________________ Territory/State ___________ Postcode _______
          Business Address ____________________________________________________________
 	               ____________________ Territory/State ___________ Postcode _______
             Business Phone _____________________ Business Fax  __________________________
Email / website address ____________________________________________________________
          		Contact _____________________ Mobile phone_________________________

Declaration – Director/Partner

Affix Company Seal Here

As a director of the company (or partner of the partnership) declare that the information contained in or attached to this notification is complete and true to the best of my knowledge and hereby appoint the Primary Nominee and Nominees listed in this notification.

           Print Full Name_______________________________________________

Primary Nominee

Signature of applicant ____________________________ Date ______________ 			
I (print full name) __________________________ agree to the appointment of being the Primary Nominee for (organisation)______________________________ in relation to architectural services
_______________________________________________________________________________provided by the firm and as a (director, partner, employee) ________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’  while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Nominee

		

Office Use Only

Date Received

Approved

I (print full name) __________________________ agree to the appointment of being the Nominee for (organisation)______________________________________ in relation to architectural services
________________________________________________________________________________provided by the firm and as a (director, partner, employee) _________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’ while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Nominee

			
I (print full name) __________________________ agree to the appointment of being the Nominee for (organisation)______________________________________ in relation to architectural services ________________________________________________________________________________
 provided by the firm and as a (director, partner, employee) ________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’  while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Nominee

		
I (print full name) __________________________ agree to the appointment of being the Nominee for (organisation)______________________________________ in relation to architectural services
________________________________________________________________________________provided by the firm and as a (director, partner, employee) ________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’ while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Nominee

			
I (print full name) __________________________ agree to the appointment of being the Nominee for (organisation)______________________________________ in relation to architectural services ________________________________________________________________________________
 provided by the firm and as a (director, partner, employee) ________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’  while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Nominee

		
I (print full name) __________________________ agree to the appointment of being the Nominee for (organisation)______________________________________ in relation to architectural services
________________________________________________________________________________provided by the firm and as a (director, partner, employee) _________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’ while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Nominee

			
I (print full name) __________________________ agree to the appointment of being the Nominee for (organisation)______________________________________ in relation to architectural services ________________________________________________________________________________
 provided by the firm and as a (director, partner, employee) ________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’  while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Nominee

		
I (print full name) __________________________ agree to the appointment of being the Nominee for (organisation)______________________________________ in relation to architectural services
________________________________________________________________________________provided by the firm and as a (director, partner, employee) _________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’ while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Nominee

			
I (print full name) __________________________ agree to the appointment of being the Nominee for (organisation)______________________________________ in relation to architectural services ________________________________________________________________________________
 provided by the firm and as a (director, partner, employee) ________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’  while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Nominee

		
I (print full name) __________________________ agree to the appointment of being the Nominee for (organisation)______________________________________ in relation to architectural services
________________________________________________________________________________provided by the firm and as a (director, partner, employee) _________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’ while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Nominee

I (print full name) __________________________ agree to the appointment of being the Nominee for (organisation)______________________________________ in relation to architectural services _______________________________________________________________________________
 provided by the firm and as a (director, partner, employee) ________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’  while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Nominee

I (print full name) __________________________ agree to the appointment of being the Nominee for (organisation)______________________________________ in relation to architectural services
_______________________________________________________________________________provided by the firm and as a (director, partner, employee) ________________________________ of the firm and understand the responsibilities required by the ‘Architects Act 2004’ while I am a nominee.
Nominee signature ________________________ Date _________ ACT Registration No. ________

Payments

NOTE: 	Appointment of Nominees - $15.00 (GST does not apply)
	Cheques should be made payable to the “receiver of public monies”
Please provide your name and address on the back of the cheque.

Payment options

IN PERSON – present your cash, cheque, money order or credit/debit card ($5.00 minimum payment and $2500.00 maximum payment for credit card) at the ACT Building, Electrical and Plumbing Control office, ground floor, north, Dame Pattie Menzies House, 16 Challis Street, Dickson, ACT (8:30 am to 4:30 pm Monday to Friday except public holidays).

BY FAX – complete the credit card details and payment details ($5.00 minimum payment and $2500.00 maximum payment for credit card) then fax it to ACT Building, Electrical and Plumbing Control on fax number (02) 6207 6324 (Bankcard, Mastercard and VISA accepted).

BY MAIL – enclose a cheque or money order or complete the credit card details and payment details ($5.00 minimum payment and $2500.00 maximum payment for credit card) then post it to Licensing Unit, ACT Building, Electrical and Plumbing Control, GPO Box 1908, Canberra ACT 2601.

Payment authority – for fax or mail payments only (see above)

ACT ARCHITECT BOARD ENQUIRIES – Please call (02) 6207 6288, facsimile (02) 6207 6324

Please charge the amount of $ ___________ to the:  Bankcard  Mastercard  Visa of:
Name of cardholder _______________________________________________________________
          Card Number _____________________________ Expiry date ________________________
           Cardholder’s
                 Signature _____________________________ Date _____________________________