Notification of Change of Conditions Form

This form will allow a station proprietor to notify us of changes regarding the following:

• - changing station details,
• - removing a vehicle examiner,
• - adding a vehicle examiner,
• - changing the proprietor.

* Indicates mandatory field.

Station details

Changing station details: *
(only one form per station type can be submitted)

• AIS
• AMBRIS
• AVCAIS

Station number: *

Vehicle examiner type: *

• VE
• MBE
• AVC

Vehicle examiner number: *

Please select and add details for all required changes.

• Cease being a station
• Change of station details

Details to be changed:

New phone number:

New postal address:

New email address:

Remove vehicle examiner

Remove vehicle examiner - number:

Remove vehicle examiner - name:

Date ceased employment:

12345678910111213141516171819202122232425262728293031 JanFebMarAprMayJunJulAugSepOctNovDec 2024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072207320742075207620772078207920802081208220832084208520862087208820892090209120922093209420952096209720982099

Add vehicle examiner

Add vehicle examiner - number:

Add vehicle examiner - name:

Change proprietor

Name of proprietor:

Email address of proprietor:

Upload National Police Certificate

This is only required if we have not received an NPC from you within the last three years

New station location

(An $88.00 site inspection fee applies to new station locations)

New location address

Payment

You will be contacted on the date and time nominated below to process an over the phone payment.

Note: Payments are not processed on weekends or public holidays (Hobart public holidays apply).

Date we should contact you:

12345678910111213141516171819202122232425262728293031 JanFebMarAprMayJunJulAugSepOctNovDec 202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072207320742075207620772078207920802081208220832084208520862087208820892090209120922093209420952096209720982099

Time we should contact you:

• 9.30 - 10.30
• 10.30 - 11.30
• 11.30 - 12.30
• 12.30 - 13.30
• 13.30 - 14.30
• 14.30 - 15.30

Declaration

I   in my capacity as Station Properietor, confirm that the above changes are true and correct at the time of submission.

Please allow two to three business days for processing.

Personal Information Protection Statement

You are providing personal information to the Registrar of Motor Vehicles, who will manage that information in accordance with the Personal Information Protection Act 2004 and relevant provisions of the Vehicle and Traffic Act 1999. The personal information collected here will be used by the Registrar of Motor Vehicles for driver licensing and vehicle registration purposes, and related purposes under the Vehicle and Traffic Act 1999 and associated laws, including for national identity matching and verification purposes. Failure to provide this information may result in your application not being processed, or records not being properly maintained. The Registrar of Motor Vehicles may also use the information for related purposes, or disclose it to third parties in circumstances allowed for by law. You have the right to access your personal information by request to the Registrar of Motor Vehicles and you may be charged a fee for this service.

Contact and Assistance

For further information contact ais@stategrowth.tas.gov.au