Document Verification Service BUSINESS USER REGISTRATION FORM & PRIVACY DECLARATION

Document Verification Service
BUSINESS USER REGISTRATION FORM
Applicant Business (full legal entity name):*
ACN/ARBN:
ABN:
NZBN:
Other relevant registration details (if any)
Physical Address:*
Postal Address:*
Applicant Business Type: (Check one only)*

(A) Agriculture, Forestry and Fishing(B) Mining(C) Manufacturing(D) Electricity, Gas, Water and Waste Services(E) Construction(F) Wholesale Trade(G) Retail Trade(H) Accommodation and Food Services(I) Transport, Postal, Warehousing(J) Information Media and Telecommunications(K) Financial and Insurance Services(L) Rental, Hiring and Real Estate Services(M) Professional, Scientific and Technical Services(N) Administrative and Support Services(O) Public Administration and safety(P) Education and Training(Q) Health Care and Social Assistance(R) Arts and Recreation Services(S) Other Services
Applicant Authorised Representative
Name:*
Position:*
Telephone:*
Fax:
Email:*
By ticking this box you confirm that the applicant organisation that you are duly authorised to represent (the Business User) has accepted and is bound by the DVS Terms and Conditions, a legally binding and enforceable contract between the Business User and Commonwealth of Australia (and each Official Record Holder) and additionally between the Business User, Austroads and BDMs in respect to its access to and use of the DVS and related matters.
Signature*

Clear
Date*

DayMonthYear
Date
PRIVACY DECLARATION
Dear Authorised Representative

As an authorised connecting agency to Australian & New Zealand government services, we have a requirement to obtain confirmation that your business has been captured under the Australian Privacy Act 1988 and/or the New Zealand Privacy Act 2020.

Please acknowledge and sign this Declaration and return it to us as soon as possible.

I, First Name* Last Name* hereby acknowledge and confirm that

your Organisation* (your Organisation) has been captured under the
Australian Privacy Act and/or the New Zealand Privacy Act 2020.
Signature*

Clear
Date*

DayMonthYear
Date
Should be Empty:

Document Verification Service

BUSINESS USER REGISTRATION FORM

Applicant Authorised Representative

PRIVACY DECLARATION