Ref. No.		
What does this application relate to?	
	
Approval of a NEW Authorised Classifier?		OR	an authorisation request to Authenticate Copies?		
	
Date approval requested by:		Date authorisation requested by:			
	
About the person    refer to the Explanatory Notes on the reverse of this form	
	
Person’s title:		Person’s full name:			
	
Position Title (within the company):			
	
Phone Number:		Fax Number:			
	
Email address:			
	
Contact address:	

Current security clearance level:		Date issued:		Expiry date:			
	
Name of vetting agency:			
	
Suitability of the new person   refer to the Explanatory Notes on the reverse of this form
	
…..as an Authorised Classifier	
Reason(s) for requesting this person to be an Authorised Classifier:			
	
List relevant training the person has been given, and by whom:			
OR
…..to authenticate copies	
Reason(s) for requesting this person be authorised to authenticate copies of records:			

Applicant’s signature, and permit details	ASNO use only	
	Approved:	____/____/______

For Director General ASNO	
Name :				
		
Position:				
	Signature:	___________________________	Date:	____/____/________		
	
Name of Permit Holder:		Permit number:			

Explanatory Notes

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 2005-003 Rev 1).	
Date approval requested by		
Access to associated items must not be granted prior to approval. Note that approvals are typically returned within 7 working days after submission of application	
Date authorisation requested by		
Application shall be made at least 5 working days prior to this date.	
Person’s full name		Must include all names, as they appear on your employment records, or on the previous authorisation approval.	
Contact Address		The address to which written notices can be sent.	
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 forms 	ASO120 (Original version) issued 1 January 2002, and ASO121 (Original version) issued 1 January 2002