Note: Please complete the form in black or blue ink. If you need more space for any of your answers, please attach a separate sheet. If an item does not apply, write ‘not applicable’.

Guidelines for Operators Seeking Access to Australian Ports under Section 94 of the Fisheries Management Act 1991 are available to assist in the completion of this form. The Guidelines can be accessed on AFMA’s website at www.afma.gov.au or by contacting AFMA.

PART A – Vessel Master’s details

Name of the vessel Master

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Nationality	Click here to enter text.
Passport number	Click here to enter text.

Contact details

Postal address

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Click here to enter text.	Postcode	text

Phone number	Click here to enter text.
Mobile/Satphone number	Click here to enter text.
Fax number	Click here to enter text.
Email address	Click here to enter text.

PART B – Fishing Master’s details

Name of the fishing Master

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Nationality	Click here to enter text.
Passport number	Click here to enter text.

PART C – Boat details

Name of boat

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Boat type (use ISSCFV codes provided in the Guidelines)

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Boat dimensions	Length:	enter text here
(in metres)	Beam:	enter text here
Draft:	enter text here

Description of boat (including details of any external identification or markings, colour scheme, gross register tonnage and regional fisheries management organisation (RFMO) ID number, if applicable)

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Please attach a photograph of the boat.

International Maritime Organization (IMO) ID number	Click here to enter text.

International radio call sign	Click here to enter text.

Current flag State(s) (use ISO 3166-1 alpha-3 codes provided in the Guidelines)

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Certificate of Registry ID number	Click here to enter text.

Previous boat name(s)

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Previous flag State(s) (use ISO 3166-1 alpha-3 codes provided in the Guidelines)

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Boat home port

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Vessel Monitoring System (VMS)

Note: It is a condition of a Port Permit that the boat must carry and operate an AFMA type-approved VMS on the boat at all times whilst in Australian jurisdiction, unless AFMA has approved other arrangements for monitoring the position of the boat.

Does the boat have a VMS?

No	☐

Yes	☐

If Yes, is it National ☐ or RFMO ☐ or both ☐

Type of VMS unit	Click here to enter text.
VMS unit ID number	Click here to enter text.

Please attach both the completed Data Network Identifer Download (DNID) Agreement Form and Inmarsat Distress Alert (IDA) Contact Details Form.

Number of crew members onboard	Click here to enter text.

Please attach a crew list giving the name, nationality, passport number and date of birth of each crew member.

PART D – Port details

Give details of the ports to which access is requested

Port Name	Click here to enter text.
Arrival	Estimated Date	Enter date here
Estimated Time	Enter time here
Departure	Estimated Date	Enter date here
Estimated Time	Enter time here
Reason(s) for port access
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Port Name	Click here to enter text.
Arrival	Estimated Date	Click here to enter text.
Estimated Time	Click here to enter text.
Departure	Estimated Date	Click here to enter text.
Estimated Time	Click here to enter text.

Reason(s) for port access
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Port Name	Click here to enter text.
Arrival	Estimated Date	Enter date here
Estimated Time	Enter time here
Departure	Estimated Date	Enter date here
Estimated Time	Enter time here
Reason(s) for port access
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Last port of call	Click here to enter text.
Date of departure	Click here to enter text.

Next port of call	Click here to enter text.
Estimated date of arrival	Enter date here

PART E – Fishing authorisations held

Details of fishing authorisations held

Authorisation type	Click here to enter text.
Authorisation ID number	Click here to enter text.
Issuing authority	Click here to enter text.
Date of expiry	Enter date here

Authorisation type	Click here to enter text.
Authorisation ID number	Click here to enter text.
Issuing authority	Click here to enter text.
Date of expiry	Enter date here

Area and scope of authorisations

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Species and quota authorised (use FAO species codes provided in the Guidelines)

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Fishing gear authorised (use ISSCFG codes provided in the Guidelines)

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PART F – Species information

Total fish species and products on board including the form of the product e.g. whether processed and if so, how (use FAO species codes provided in the Guidelines)

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Catch location

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Processed weight and equivalent live weight

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Type and quantity of catch to be offloaded

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PART G – Transhipment information

Details of relevant transhipment authorisations

Authorisation type	Click here to enter text.
Authorisation ID number	Enter Text here.
Issuing authority	Click here to enter text.
Date of expiry	Click here to enter a date.

Authorisation type	Click here to enter text.
Authorisation ID number	Enter Text here.
Issuing authority	Click here to enter text.
Date of expiry	Click here to enter a date.

Transhipment concerning donor boat(s)

Note: Where there have been transhipments concerning more than one donor boat, please provide details on a separate sheet and attach.

Date of transhipment	Click here to enter a date.
Location of transhipment	Click here to enter text.
Name of donor boat	Click here to enter text.
Flag State of donor boat (use ISO 3166-1 alpha-3 codes provided in the Guidelines)	Click here to enter text.
Certificate of Registry ID number of donor boat	Click here to enter text.
Species transhipped including the form of the product e.g. whether processed and if so, how (use FAO species codes provided in the Guidelines)	Click here to enter text.
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Catch location	Click here to enter text.
Total quantity transhipped	Click here to enter text.

PART H – Vessel owner’s details

Name of the vessel owner

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Postal address

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Click here to enter text.	Postcode	text

PART I – Beneficial owner’s details

Name of the beneficial owner

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Postal address

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Click here to enter text.
Click here to enter text.	Postcode	text

PART J – Vessel operator’s details

Name of the vessel operator

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Postal address

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Click here to enter text.
Click here to enter text.	Postcode	text

PART K – Agent’s details

Name of Agent

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Contact details

Postal address

Click here to enter text.
Click here to enter text.
Click here to enter text.	Postcode	text

Phone number	Enter Text here.
Mobile number	Enter Text here.
Fax number	Enter Text here.
Email address	Enter Text here.

PART L – Applicant’s details

Name of Applicant

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Contact details

Postal address

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Click here to enter text.
Click here to enter text.	Postcode	text

Phone number	Enter Text here.
Mobile number	Enter Text here.
Fax number	Enter Text here.
Email address	Enter Text here.

PART M – Declaration by Agent/Applicant

IMPORTANT

Please read “Who can sign this form’ on page 5 before completing this Declaration.

Giving false or misleading information is a serious offence.

I, the Agent detailed in PART K or the Applicant detailed in PART L:

apply for the grant of a Port Permit in respect of the boat described in PART C, and

declare that the information provided on this form is, to the best of my/our knowledge, true and correct.

Signature
Date	Click here to enter a date.
Full Name	Click here to enter text.

Position held (if applicable)

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In the presence of (Full name of Witness)

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Signature of Witness

Checklist of attachments

The attachments to this application are:

Photograph of the boat clearly showing any external identification and distinguishing markings/symbols	☐

Data Network Identifer Download (DNID)	☐

Agreement Form

Inmarsat Distress Alert (IDA) Contact Details Form	☐

Crew List	☐

Guidance notes for completing this form

This form should be completed to apply for a Port Permit to allow a foreign fishing boat to enter a Commonwealth port.

There is a fee associated with the application for a Port Permit.

What you need to do

Post, fax or email this completed form along with the required attachment(s) to:

Australian Fisheries Management Authority

Box 7051

Canberra Business Centre ACT 2610

Fax: +61 2 6225 5440

Email: portpermit@afma.gov.au

Who can sign this form?

Any person acting on behalf of the operators of the foreign fishing boat specified in PART C, and by signing this form they represent having authority of the operators of the specified foreign fishing boat.