Movement of bulbs to another quarantine approved premises

Contact person

Title

Given name Family name

Work phone (include area code) Mobile phone

Email Fax (include area code)

2. 
   Bulb transfer date (dd/mm/yyyy)
   

3. Have you provided copies of Import Permit conditions and biosecurity directions to the receiving approved arrangements site?

Tick one box only

No Yes

If ‘No’, provide details

4. Will this bulb transfer involve intervention by a state government biosecurity authority?

Tick one box only

No Yes

5. Commodity details (attach a separate sheet if necessary)

AIMS entry number	Bulb type (genus, species and variety)	Quantity to be transferred	Certified or non-certified

Section C: Bulb receipt

To be completed by the receiving approved arrangements site upon arrival of the bulb consignment

6. Receiving approved arrangements site

Approved arrangements site number

Approved arrangements site name

Australian Business Number (ABN) Australian Company Number (ACN)

Street address

Suburb/town/city State/territory Postcode

Contact person

Title

Given name Family name

Work phone (include area code) Mobile phone

Email Fax (include area code)

7. 
   Bulb arrival date (dd/mm/yyyy)
   

8. Did this bulb transfer involve intervention by a state government biosecurity authority?

Tick one box only

No Yes

Section D: Transferring approved arrangements site declaration

To be completed by the person listed in Section B of this application. I declare that the information I have provided is true and correct.

I will abide by all biosecurity conditions the Department of Agriculture and Water Resources imposes on the handling of this product.

I understand that it is a criminal offence under the Criminal Code Act 1995 to knowingly give false or misleading information to a Commonwealth officer exercising powers under Commonwealth law. This offence carries a maximum penalty of 12 months imprisonment.
Signature Date (dd/mm/yyyy)

Full name

Section E: Receiving approved arrangements site declaration

To be completed by the person listed in Section C of this application.

I declare that the information I have provided is true and correct. I have also informed the relevant regional office that the bulbs have arrived.

I will abide by all biosecurity conditions the Department of Agriculture and Water Resources imposes on the handling of this product.

I understand that it is a criminal offence under the Criminal Code Act 1995 to knowingly give false or misleading information to a Commonwealth officer exercising powers under Commonwealth law. This offence carries a maximum penalty of 12 months imprisonment.

Signature Date (dd/mm/yyyy)

Full name

Section F: Privacy notice

‘Personal information’ means any information or opinion about an identified, or reasonably identifiable, individual.
The collection of personal information by the Department of Agriculture and Water Resources in relation to this document is authorised under the Biosecurity Act 2015. If you do not provide the relevant personal information requested in this document, the department will be unable to complete a full biosecurity risk assessment and/or contact you if future biosecurity risks emerge. Personal information may be disclosed to other Australian agencies, including the Department of Immigration and Border Protection, Australian Border Force and persons or organisations where necessary for these purposes, provided the disclosure is consistent with relevant laws, in particular the Privacy Act 1988. Your personal information will be used and stored in accordance with the Australian Privacy Principles.
See the department’s Privacy Policy to learn more about accessing or correcting personal information or making a complaint. Alternatively, telephone the department on [phone].

Movement of bulbs to another approved arrangements site


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