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BROKER ABN Date C RESULT U FILE NO OFFICER SIGNATURE ADVICE STATUS DECISION DATE OFFICER NAME TELEPHONE DESIGNATION DATE NOTE Before completing this form you should read Section 3 of Division 8 of Customs Manual Volume 8D titled Origin Rulings - information requirements which has full details of information required to be provided on this Application for Origin Ruling form. B184 12/04. APPLICATION FOR ORIGIN RULING THAILAND-AUSTRALIA FREE TRADE AGREEMENT The Privacy Act 1988 requires us to tell you why we are collecting this information how we will use it and whether we will disclose it. Customs will use this information to determine whether your goods are Thai originating goods in accordance with the Thailand-Australia Free Trade Agreement and are therefore eligible to be imported at a preferential rate of customs duty. Customs is not permitted to disclose this infomation except when required or authorised to do so by law. If this form was completed by a business with fewer than 20 employees please provide an estimate of the time taken to complete this form* Hours 1. APPLICANT S NAME A P L I C N T Minutes ADVICE NUMBER U S O M S 5. DATE LODGED 2. ADDRESS 3. ABN 4. TELEPHONE NUMBER / 5. CONTACT NAME DD/MM/YY 6. DOCUMENTATION ATTACHED YES NO 7. TARIFF CLASSIFICATION OF GOODS 8. DESCRIPTION OF GOODS DESCRIPTION OF MATERIALS USED IN THEIR MANUFACTURE INCLUDING WHETHER THOSE MATERIALS ARE THAI/AUSTRALIAN ORIGINATING THE TARIFF CLASSIFICATION OF ANY NON-ORIGINATING MATERIALS IF KNOWN AND THE PROCESS USED TO MANUFACTURE THE GOODS R B K YES 9. PREVIOUS ADVICE FOR THESE GOODS E 11. SUPPLIER S CUSTOMS CLIENT ID NUMBER MORE Y/N 12. BROKER S REF O 13. NAME AND ADDRESS OF SUPPLIER 14. BROKER S NAME E 15. BROKER COMPANY E 17. Signature of APPLICANT/BROKER 16. APPLICATION FOR ORIGIN RULING THAILAND-AUSTRALIA FREE TRADE AGREEMENT The Privacy Act 1988 requires us to tell you why we are collecting this information how we will use it and whether we will disclose it. Customs will use this information to determine whether your goods are Thai originating goods in accordance with the Thailand-Australia Free Trade Agreement and are therefore eligible to be imported at a preferential rate of customs duty. Customs will use this information to determine whether your goods are Thai originating goods in accordance with the Thailand-Australia Free Trade Agreement and are therefore eligible to be imported at a preferential rate of customs duty. Customs is not permitted to disclose this infomation except when required or authorised to do so by law. Customs is not permitted to disclose this infomation except when required or authorised to do so by law. If this form was completed by a business with fewer than 20 employees please provide an estimate of the time taken to complete this form* Hours 1. If this form was completed by a business with fewer than 20 employees please provide an estimate of the time taken to complete this form* Hours 1. APPLICANT S NAME A P L I C N T Minutes ADVICE NUMBER U S O M S 5. DATE LODGED 2. ADDRESS 3. ABN 4. TELEPHONE NUMBER / 5.

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