APPLICATION FOR CONFIRMING

EXPORTER STATUS

Approved Form - Customs Act s114B(2)(b)

NOTICE
We require this information under the Customs Act 1901, so we can assess your eligibility for
confirming exporter status. The information you provide may be given to the Australian Bureau
of Statistics. If you are required to hold a permit to export the goods for which you are applying
for confirming exporter status then it may also be given to the relevant permit issuing authority.

(Customs use only)

Customs file Confirming exporter

reference: status approval notice:

I hereby apply for confirming exporter status under section 114B of the Customs Act 1901
The following details are supplied in support of the request:

1 Exporter
1a. Name of exporter:

1b. Customs Client ID (CCID) or Australian Business Number (ABN):

1c. Branch ID (if applicable):

2 Schedule of goods (if insufficient space add additional pages)

Goods description:

AHECC range: Confirmation period: (days)

to
Information which cannot be Customs First port of
ascertained prior to exportation: Net quantity Gross weight
export value discharge
Goods description:

AHECC range: Confirmation period: (days)

to
Information which cannot be Customs First port of
ascertained prior to exportation: Net quantity Gross weight
export value discharge
Goods description:

AHECC range: Confirmation period: (days)

to
Information which cannot be Customs First port of
ascertained prior to exportation: Net quantity Gross weight
export value discharge
Goods description:

AHECC range: Confirmation period: (days)

to
Information which cannot be Customs First port of
ascertained prior to exportation: Net quantity Gross weight
export value discharge
Goods description:

AHECC range: Confirmation period: (days)

to
Information which cannot be Customs First port of
ascertained prior to exportation: Net quantity Gross weight
export value discharge
B111 (AUG 2003)
3 Reasons
3a. Reasons why the information cannot be ascertained prior to exportation:

Supporting documents are attached

3b. Reasons why the information cannot be ascertained before the time requested in the schedule of goods:

Supporting documents are attached

3c. Steps that have been taken to ascertain the information earlier:

Supporting documents are attached

4 Conditions
If the CEO grants you confirming exporter status, it will be subject to the following conditions. You must:
specify the appropriate confirming exporter status in any export declaration relating to the goods in respect of which the status was granted
where I propose to rely on that status; and
provide full details of the information in respect of which the status was granted as soon as practicable after exportation and not later than the
time the CEO indicates in the notice granting the status; and
notify forthwith the CEO if information in respect of which the status was granted becomes, to my knowledge, able to be ascertained before
the exportation of goods in respect of which the status was granted; and
submit to Customs in each export declaration relating to the goods in respect of which the status was granted, a reasonable estimation of the
information that I am unable to ascertain prior to exportation.
If the CEO grants you confirming exporter status, your status may be subject to additional conditions which will be included in the
confirming exporter status approval notice.

Cancellation and modification of status

Where the CEO is satisfied that information in respect of which confirming exporter status was granted is now able to be ascertained before exporta-
tion, he or she must sign a notice in writing:
cancelling the confirming exporter status forthwith; or
modifying the confirming exporter status so that it no longer relates to that information.

Failing to comply with a condition

If you fail to comply with a condition to which the grant of confirming exporter status in respect of information and goods is subject, then you
are guilty of an offence (Penalty: 10 penalty units).
This is an offence of strict liability.
If you are convicted of such an offence; or
if the CEO becomes satisfied that you failed to comply with a condition of a grant of confirming exporter status although no proceedings for an
offence have been brought against you
the CEO may:
cancel your status as a confirming exporter in respect of that information and those goods; or
modify your status as a confirming exporter so that it no longer relates to specified information or goods or so that the conditions to which it is
subject are altered in a specified respect;
by signing a notice stating that that status has been so cancelled or modified and setting out the reasons for that cancellation or modification.

5 Declaration: I hereby declare that the information provided in this application is complete and correct.
Signature: Date:
/ /

Name of person signing applicaiton: Position in company of person signing application:

Company:

Address:

Telephone number:

Fax number:

Email address: