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Used to apply for a licence to conduct activities specified in subclause 149(1) of the Coal Mine Health and Safety Regulation 2006. Application can be made by an individual or a corporation. LODGEMENT INSTRUCTIONS 1. You must complete all sections of this form. 2. You must lodge your application with New South Wales Department of Primary Industries (NSW DPI) at the address below. 3. You must sign each page of this application. 4. You must sign and date the declaration on the last page. APPLICAT.

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How to fill out the AU GNC-010 A online

This guide provides clear and comprehensive instructions on how to fill out the AU GNC-010 A form online. By following the steps outlined, you will be able to complete your licensing application efficiently and accurately.

Follow the steps to successfully complete your application.

  1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
  2. Begin by filling out the applicant details section. If applying as an individual, provide your title, family name, given name, and other names if applicable. Indicate your gender and enter your date of birth. Make sure to include your home telephone and mobile number, as well as your email address.
  3. Complete your address details accurately. Fill in both your postal address and home address if they differ. Ensure your age is clearly stated and provide any relevant criminal offence details if applicable.
  4. If you have qualifications related to the licensed activity, list them in the relevant section. Include certified original documents as required.
  5. Proceed to complete the section regarding your relevant experience and references. This may include details of any previous roles that relate to the activities for which you are seeking a licence.
  6. Select the licensed activity for which you are applying by ticking the appropriate box. Ensure you understand the specific requirements of the selected activity.
  7. Review the applicant’s declaration. As an individual or representative of a corporation, confirm that all information provided is true and correct, sign, and date the declaration.
  8. Check your application using the provided checklist to ensure all components are completed and signed where necessary before submission.
  9. Finally, save your changes, download the completed form, and print it for record-keeping. Prepare for submission by following the lodgment instructions provided at the end of the form.

Ready to submit your application? Complete your AU GNC-010 A form online today.

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