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1
Application details
2
Trading information
3
Principal Business contact information
4
Complaint Handling contact information
5
Accounts contact information
6
Privacy information
Application details
Company name
Must match company name registered with ASIC under ACN
ACN
Trust/Sole trader name
ABN
Trading names/Brands
By which customers may know this entity
Type of organisation
e.g. sole trader, partnership, public company etc
ACMA licence
Does the Applicant hold a carrier licence issued by the Australian Communications and Media Authority?
ACMA licence
Yes
ACMA licence
No
Provide the date of issue
Registered address
Unit number (Registered)
Street Number (Registered)
Street number and name
Global address key (Registered)
Suburb or town
State
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Postcode
Ultimate holding company if applicable
A group or holding company that owns the company applying
Has the applicant previously traded under another name?
Has the applicant previously traded under another name?
Yes
Has the applicant previously traded under another name?
No
Previous trading name
Date trading ended under this name
Postal address is the same as the registered address
Postal address is the same as the registered address
Yes
Postal address is the same as the registered address
No
Postal address
Address unit number (Postal)
Adress street number (Postal)
Street number and name
Suburb
State
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Postcode
Company postal address validation global key
Website
Public email
Customer service number
Leave this field blank
