Section A: General information



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2014/2952logo of the australian government department of agriculture and water resources

APRIL 2015


Movement of bulbs to another approved arrangements site




Section A: General information



Purpose of this form


Before moving bulbs

For the biosecurity industry participant of an approved arrangements site to transfer plant bulbs to another approved arrangements site.

Only plant bulbs that have been inspected and treated by the Department of Agriculture and Water Resources on arrival in Australia are eligible.
Check the requirements for an approved arrangement for bulbs (class 6.11) available on the department’s website.


To complete this form


Electronically

You will need the latest version of Adobe Acrobat Reader to save changes to your document and submit.


Manually


Use black or blue pen Print in BLOCK LETTERS

Mark boxes with a tick or a cross.




Your obligations


Complete a separate request form for each bulb transfer and ensure it is signed by both the transferring approved arrangements site and the receiving approved arrangements site.

Both approved arrangements sites must keep a signed copy of the form on file and present it on request to the Department of Agriculture and Water Resources.





1346_0214





Section B: Bulb transfer


To be completed by the transferring approved arrangements site before the bulbs are dispatched
  1. Transferring approved arrangements site





Approved arrangements 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)



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


  1. 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




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

Tick one box only


No Yes




  1. 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

  1. 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)



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

  1. 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 +61 2 6272 3933.


Movement of bulbs to another approved arrangements site


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