Phone No:	Email:	Confirm Email:	Commencement of Proposed handling / transfer
			Date:		Time:

The Shipping Company, by its Agent, applies to:

Transship

Unload

Load

Handle

dangerous goods and/or bulk liquids to/from the ship, as specified in the attached Dangerous Goods / Bulk Liquids List and, more particularly to:

	Handle goods other than dangerous goods in a hold in which dangerous goods are stowed as specified in the attached Dangerous Goods List
	Handle goods other than dangerous goods on or above open deck space on which dangerous goods are stowed as specified in the attached Dangerous Goods List
	Retain on ship dangerous goods in transit as specified in the attached Dangerous Goods List
	Handle dangerous goods between the hours or sunset and sunrise as specified in the attached Dangerous Goods List
	Handle goods other than dangerous goods between the hours or sunset and sunrise on a ship which has on board dangerous goods as specified in the attached Dangerous Goods List
	Transfer of non-hazardous bulk liquids (eg tallow, vegetable oil etc)

I certify to the best of my knowledge, information and belief (tick whichever applicable)

I am duly authorised to make this application on behalf of the Shipping Company.

This application will incur a fee of $311.09 GST INC

Signature	Date of Application