APPLICATION FOR RENEWAL OF AP ETROLEUM EXPLORATION PERMIT - DOC by 0s7iRTF

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									       APPLICATION FOR A PETROLEUM SPECIAL PROSPECTING AUTHORITY
                                        in accordance with
            Part 2.7 of the Offshore Petroleum and Greenhouse Gas Storage Act 2006


  Survey Name

  Commencement Date

  Conclusion Date


  Applicant(s)                                                                   ASIC ACN/ARBN No.
  (Company or Individual Name(s))                                                    (if applicable)




  Mapsheet(s)
  (Note: if there is more than one mapsheet please provide a separate
  listing of block number(s) for each mapsheet)


  Blocks Number(s)
  (Note: if there is insufficient space allowed please attach additional page)




  Name of Vessel/Aircraft

  Proposed Line km or km²

  Estimated cost (A$)

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                                       CONTRACTOR CONTACT DETAILS

   Company Name

   Company Address

   Postal Address
   (if not the same as above)
   Contact Name

   Position Held

   Phone

   Fax

   Email




  Application for Petroleum Access Authority attached      Click Here to Enter



  Payment of Application Fee
  (Cheque or Direct Deposit)

  NOPTA Use Only (Receipt number)



                                      APPLICANT CONTACT DETAILS

  Company Name

  Company Address

  Postal Address
  (if not the same as above)
  Contact Name

  Position Held

  Phone

  Fax

  Email




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Executed in accordance with section 234 of the Offshore Petroleum and Greenhouse Gas Storage
Act 2006.

EXECUTED BY




Signature                                       Date


Full name (please print)                        Position




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         THE FOLLOWING DETAILS SHOULD BE ATTACHED TO AN APPLICATION

Checklist
1. Particulars and objective of the petroleum exploration operations that the applicant           Click here
   proposes to carry out;

2. A map showing the 1:1,000,000 map sheet and graticular block numbers to which the
                                                                                     Click here
   application applies;

3. Technical details of the vessel (if not previously supplied); and                              Click here

4. Any other information the applicant wishes to be considered.                                   Click here



Submission Details

By courier                            Via post                            Via email

Titles Manager                        Titles Manager
NOPTA                                 NOPTA                               titles@nopta.gov.au
Level 8                               GPO Box 7871
Alluvion House                        Perth WA 6850
58 Mounts Bay Road
Perth WA 6000

* For Melbourne Office submission details refer to the NOPTA website Contact Us



Application Fee
Please make cheques out to: “Department of Resources, Energy and Tourism”
Please write your full company name, ABN and “Special Prospecting Authority Application Fee” on the
back of the cheque, and include with your application.

Direct Deposit
BSB: 092-009 Acct No: 119-585
Reference: Please insert the first 3 letters of your company name and “SPA” in the reference field to
ensure your payment can be processed.
Please also include a note with your application if you have paid your fee by direct deposit.


NOTES
A Special Prospecting Authority authorises a person to undertake exploration work other than drilling a well,
in vacant acreage. The maximum term of a Special Prospecting Authority is 180 days.
Applications should be lodged at least 30 days prior to commencement. However, to allow for timely
approvals, it is recommended that applications be submitted 90 days prior to commencement of operations.

In making an application please refer to the Offshore Petroleum and Greenhouse Gas Storage Act 2006. The
Guidelines “Special Prospecting Authorities, Access Authorities & Scientific Investigation Consents” contain
further details in respect to applications for Special Prospecting Authorities.




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