Commonwealth Numbered Regulations

1995 No. 389 OZONE PROTECTION REGULATIONS - SCHEDULE 1

                             SCHEDULE                  Regulation 4

COMMONWEALTH OF AUSTRALIA
Ozone Protection Act 1989
Form 1
APPLICATION FOR EXEMPTION UNDER REGON 40
1.    Name of applicant:

2.    Address of applicant, if applicant is not a company:

3.    Address of Registered Office, if applicant is a company:

4.    If applicant is a company-State, Territory or place outside

Australia where the company is incorporated:
5.    If the applicant is a company-the Australian Company Number of

the company:
6.    Address of applicant for correspondence:

7.    Name of contact person (if applicable):

8.    Telephone and facsimile numbers (if any) of applicant or (if

applicable) of contact person-
telephone:
facsimile:
9.    Details of the exemption sought including:


   (a)  product or scheduled substance involved:

   (b)  quantity involved:

   (c)  provision of Act or Regulations from which exemption is
sought:
10.   Period for which exemption is sought:

11.   If the exemption is essential for medical, veterinary, defence,

industrial safety or public safety purposes, give relevant
details:
12.   If the exemption is sought because of the provisions of a law

concerning the manufacture or use of the product in relation to
which exemption is sought, give relevant details:
13.   If the exemption is sought in relation to the calibration of

scientific, measuring or safety apparatus, give the relevant
details:
14.   If there is an alternative to the use of a scheduled substance

known to the applicant in the operation or manufacture of a
product in relation to which exemption is sought, give relevant
details including investigations undertaken.
Dated the        day of      19 .
........................................................ (signature) Name of
signatory*:

* If the applicant is a body corporate specify the relationship of signatory
to the body corporate: