Ref. No.		

Signature and permit details		____________________	
	Name :		Position:			
			
	Permit Holder:		Permit No.			Signature:

Date:  ____/____/________	

Explanatory Notes

** This is a copy of the IAEA (International Atomic Energy Agency) form used by Australia to make nuclear material 
inventory change reports to the IAEA under the “Error! Use the Home tab to apply CharChapText to the text that you want to appear here.” **

Using this form		•	Use as many ASO319 forms as is necessary to list all inventory changes for the reporting period.
•	Equivalent forms approved by the Director General ASNO may be submitted in place of this form.
•	Data entered onto this form must be in the fixed format described in the IAEA’s document titled ‘Model Code 10’.	
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).	
Material Balance Area		
As defined in your permit.	
Signature and permit details		
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.	
Submitting this form		
This form must be submitted to ASNO by 15th day of each month covering transactions completed in the previous calendar month.