Ref. No.		
Which location?	
	
Facility or LOF to be updated:			
	
Facility address to be updated (if applicable):			
	
When?    Refer to Explanatory Notes on the reverse of this form
	
Expected start date:		Expected completion date:			
	
Change details
	
Description of change(s):			
	
Reasons for the change(s):			
	
Name of contact person regarding change:			
	
Phone number:		Fax Number:			
	
Email address:			
	
Contact address:			

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

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).	
Expected start date		Changes must be notified 60 days prior to commencement of the change(s) to enable ASNO to comply with its obligations to the International Atomic Energy Agency.	
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 	ASO225 (original issued 5 May 2003)