Ref. No.		
Vessel details	
	
Current name of vessel:		IMO No:			
	
Gross tonnage:		Shipping line from Australia/ 
Charterer:			
	
Registered owner:		Country of registration:			
	
Classification society	
DNV GL?	;	Lloyd’s Register of Shipping?	;	Other?				
	OR	Please specify	
Bureau Veritas? 	;	American Bureau of Shipping? 	;	
	
   Vessel conveying UOC through High Risk Areas
	
Will this vessel convey Australian obligated UOC through a High Risk Area?			
	
Does the freeboard height exceed 8 m?		Will the vessel be able to maintain a
 minimum 18 knots navigating the HRA?			

Applicant’s signature, and permit details	
	
Name :			Where ASNO approves this application, the Permit Holder will note the Expiry Date listed below		
			
Position:					
Signature:	    ______________________________	 Date:    ____/____/_________
	
Name of Permit Holder:		Permit number:			
	
   ASNO USE ONLY
Actions:
1.	Checked Equasis	
2.	Checked AMSA	
3.	NUMBAT updated	
4.	Approved for HRA		Expiry date:
This approval – to use this vessel for: 
1. UOC shipments from Australian Port
    will expire on:
		____/_____/_______
2. UOC conveyance through HRAs
    will expire on:
	____/_____/_______	
Approved:	____/____/________

________________________
For Director General ASNO	

Explanatory Notes

This application must be lodged with ASNO not less than 5 business days prior to export.

Ref. No		A sequential reference number is required for each form of this type submitted by the Permit Holder (eg 001, 002, 003 etc). Where amendments are made to a previously submitted form, please use the same reference with a sequential revision number (eg, 003 Rev 1).	
IMO No.		This is the unique ship identification number issued to a vessel by IHS Fairplay (previously Lloyd's Register-Fairplay), assigned to sea-going merchant ships under the International Convention for the Safety of Life at Sea (SOLAS).	
Shipping Line		Holder of a Transport Permit in accordance to section 16 of the Act.	
Country of registration		
Is also referred to as the Flag State.	
Classification society		
A classification society (however called) is a non-governmental organisation that establishes and maintains technical standards for the construction and operation of ships and offshore structures.	
High Risk Area	
(HRA)	With respect to vessels that navigate areas of high risk associated with piratical attacks or specific ports and anchorages associated with armed robberies on board ships.	
Freeboard height		The freeboard assigned in meter is the distance measured vertically downwards from the deck line at its lowest point able for unauthorised boarding, to the waterline. Please specify freeboard during passage through the HRA.	
Applicant’s signature		
This form must be signed by a representative of the Permit Holder (ie, the organisation) who will take responsibility for, and sign documents on behalf of, the organisation.	

This form replaces the following form 	ASO111 (Version 4 issued 21 January 2011)