Export Licence Questionnaire
Applicant Type
Sole Trader
Partnership
Company
Other
Best Contact Number
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the postal address different to your business address?
*
Yes
No
ABN Number
*
ACN (If applicable)
Trading Name(s) to be used on export documentation
Has the applicant (whether a sole trader, partner, company director or trustee) previously held an export licence?
*
Yes
No
Please enter the exporter ID of previous licence (if known)
What was the name of the pervious licence holder?
Do you pay the Wine Grapes Levy?
*
yes
No
Has the applicant or any of the applicant's advisors, partners, representatives, employers, employees or related body corporates (within the meaning of the Corporations Act 2001) ever held a licence to export grape products from Australia that has been cancelled or suspended?
*
Yes
No
Please provide details of the relevant party and your association with that party
Has the applicant or any of the applicant's advisors, partners, representatives, employers, employees or related body corporates (within the meaning of the Corporations Act 2001) ever been convicted of an offence under the Wine Australia Act 2013 or any similar legislation?
*
Yes
No
Please provide details of the relevant party and your association with that party
Has the applicant or any of the applicant's advisors, partners, representatives, employers, employees or related body corporates (within the meaning of the Corporations Act 2001) ever had an application for the approval of a grape product (or the shipment of a grape product) refused or revoked by Wine Australia or its predeccessors?
*
Yes
No
Please provide details of the relevant party and your association with that party
Submit
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