Ref. No.		
What type of change?	
	
To the accountancy and control system?		OR	to the security measures?		
	
Details about the change	
	
Summary description of the change(s):			
	
Proposed date of effect:			
	
Reason(s) for change(s):			
	
NOTE:	Attach—as applicable—copies of changed documented procedures, and/or detailed descriptions covering physical changes.	

Signature and permit details	
	
Name :			
	
Position:			
	Signature:	_____________________________________	Date:	____/____/________	
	
Permit Holder:		Permit No:			

Number of enclosures		Total number of pages:			

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, 003-Rev.1).	
Proposed date of effect		
The notification shall be forwarded to ASNO within three days of the change being implemented.	
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 	ASO215 (Version 2 issued 9 June 2006)