Ref. No.		
Current details
	
Name of Permit Holder as it appears on the current Permit(s):			
	
Permit Number(s):			
	
Details of changes
	
Name of new Permit Holder 			
	
Address for receiving correspondence:			
	
Has the name of the Permit Holder’s designated individual changed?	YES		NO	
NOTE:	If ‘YES’, then ASNO form ASO214 (Notification of Designation of an Individual) must be completed and sent to ASNO also.
Form ASO214 completed/sent to ASNO?	 (if applicable)	
Partnerships or Unit Trusts	
Total number of pages comprising the list of partners (or trustees)?		Refer to Explanatory Notes on the reverse of this form	
	
Reasons for change(s) in particulars 
	
Organisational name change?	
Organisational restructure?	
Incorporation into another organisation?	
Sold to another organisation?		
Other?		
For ‘Other’, please provide details:			
	
Signature	
	
Name :			
	
Position:			
	Signature:	_____________________________________	Date:	____/____/________	

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).	
Details of changes		This form is to be completed and sent to ASNO within 14 days from the date of effect of changes to the Permit Holder’s particulars.	
Partnerships or Unit Trusts		
Where the Permit Holder is a partnership (or unit-trust), then the list of partners (or trustees) shall clearly identify the names of those:
(a)	to be removed,
(b)	to be added, and 
(c)	that are to remain.

All pages comprising the list shall be signed and dated by the same person signing this notification.	
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 	ASO231 (Original issued 20 February 2003)