Change of address

Personal details

First name:

Last name:

Contractor/Business name:
( If applicable?)

Date of birth:

Contact phone:

Email:

Old address

Existing address on licence:

Suburb:
State/Territory and
Postcode:

New address

New address:

Suburb:
State/Territory and
Postcode:

Type of licences

Please note the applicable licence/certificate or registration numbers in the right column which aligns with the type of licence you are referring to

Accredited medical practitioner (Tas Med Provider No.)

Automotive gasfitter

Building practitioner accreditation

Certificate of competency (Natural Gas) Type A or B

Construction induction (White card)

Dangerous goods driver licence

Dangerous goods vehicle licence

Licence to perform high risk work

Occupational licensing - Contractor number

Occupational licensing - Practitioner number

Registered assessors for high risk work

Shot firer

Magazines

Please select magazine/s you are subscribed to receive if you require us to amend your mailing address for those as well.

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Any additional information