(1) Form Completion
APPLICATION FOR ARESOURCE EXPLORATION ACCESS PERMIT
Pursuant to Woomera Prohibited Area Rule 2014 use this form to: Apply for a new Permit or renewal for exploration tenements in the Woomera Prohibited Area (WPA)
INSTRUCTIONS
(1) Form completion
Please complete all Sections in the Form. If further space is required, please use last page to record additional information.Defence will process your permit application within 25 business days of receipt of a correctly completed application. Defence may also require additional information or documents in considering an application for a Permit. Applicants will be advised if additional information or documents are required and the processing time will be extended by the time it takes for the applicant to provide.
Defence may seek information from the South Australian Department of State Development when processing an application.
(2) Form submission
Completed applications should be submitted to:Email: (preferred method)
Mail: Woomera Prohibited Area Coordination Office (WPACO)
R1-1-D Zone
PO Box 7901
Canberra BC ACT 2610
Phone Enquiries: 1300 727 420
(3) Access to the Woomera Prohibited Area
Approved Person Status and Escorted PersonsThe permit holder must take all reasonable steps to ensure that all persons who enter under the permit hold an Approved Person status or are an Escorted Person.
- Approved Person Status: An application form to apply for Approved Person Status (Form W003) can be found on the WPACO website Defence will process the application within 20 Business Days of receipt of a correctly completed application. Defence may also require additional information or documents in relation to the application. The processing time will be extended by the time it takes for the additional information or documents to be provided.
- Escorted Person: The permit holder is to provide written notification of escorted persons using form Notification of Escorted Person W004. The Escorted Person status is valid for a total of 5 days within the 2 year validity status period (whether or not they are consecutive days) after which time an application for Approved Person status should be submitted if required.
The issuing of a Permit and the granting of Approved Person status and notification of Escorted Person details does not give the right of entry onto the WPA. The permit holder must give at least 10 business days’ notice before entering the WPA under the permit. This access notification is to be provided by submitting Access Form W007 which includes the dates of entry and a list of the Approved Persons and Escorted Persons who will be entering.
The Access Form, W007 is available from the WPACO website at The completed form W007 is to be submitted to the WoomeraTestRange:
Email: (preferred method)
Mail: WoomeraTestRange, PO Box 157, WOOMERA SA 5720
PRIVACY STATEMENT
This information is being collected by the Woomera Prohibited Area Coordination Office (WPACO)on behalf of the Department of Defence asauthorisedby theWoomera Prohibited Area Rule 2014.
A copy of the WPACO Privacy Policy is available at [insert link] and details how personal information is collected, used and stored. The WPACO Privacy Policycontains information on how an individual may apply for access to their personal information and how an individual may apply to have their personal information amended. The Defence Privacy Policy also contains information for individuals on how to make a privacy complaint to Defence if they consider Defence may have breached the Australian Privacy Principles.
SECTION A: APPLICATION TYPE
Select one / Application for a new Resource Exploration PermitApplication to renew a Resource Exploration Permit
Application for a Resource Exploration Permit to replace an existing Deed of Access
Tenement Number(s)
SECTION B: APPLICANT DETAILS
Company Name
ABN / ACN
Company Website
Application made by a subsidiary company? / Yes / Provide name of parent company
Registered address line 1
Registered address line 2
Suburb/Locality / State / Postcode
Check this box if Postal address is the same as company registered address
Postal address line 1
Postal address line 2
Suburb/Locality / State / Postcode
Telephone / Fax
Contact person for administration queries / Tick if the primary contact for this application
Contact name
Position
Mobile / Other Phone / Fax
Company Representative / Tick if the primary contact for this application
The Company is required to appoint, and for the duration of the Permit Term, maintain the appointment of a Company Representative(s) who has the authority to bind the Company. The Company must also notify an alternative point of contact if the Company Representative is unavailable for any reason and also any changes to the Company Representative.
Contact name
Position
Mobile / Other Phone / Fax
Alternate Contact name
Position
Mobile / Other Phone / Fax
Please check this box if an alternative Company Representative will be advised at a later date
Company Information
Company Directors / 1 / 5
2 / 6
3 / 7
4 / 8
Major Shareholders
(in descending order) / 1 / 4
2 / 5
3 / 6
SECTION C: COMPANY STRUCTURE
Company Ownership and Control
Is the company a foreign person under the Foreign Acquisitions and Takeovers Act 1975 (theAct) or the subject of a foreign investment proposal under the Act or Australia’s Foreign Investment Policy? / Yes / No
Do persons outside of Australia influence or direct the business of the organisation's board of directors (or similar governing body), officers, executive personnel, general partners, trustees or senior management officials? / Yes / No
Do persons outside of Australia have the power to directly or indirectly control the election, appointment or tenure of members of the organisation's board of directors (or similar governing body) or other management positions of the organisation? / Yes / No
If you indicated ‘yes’ to any of the above, please provide details below.
Structure for Operations
Are any tenements subject to a Joint Venture (JV)or Farm-in agreements? / Yes / No Move to Section D
Names of all JV partners / Tenement Number/s
a. / a.
b. / b.
c. / c.
d. / d.
An application form W001 must be completed for each JV or Farm-in partner. However, If the JV or Farm-in partner has an existing Exploration Permit an application form W001 may not be required subject to confirmation that there have been no changes since their previous application.
Is the application form W001 being submitted by all JV or Farm-in partners?
Yes / No Please provide reason below
Provide details below on intended joint venture or Farm-in partnership arrangements for any tenement covered by this application.
SECTION D: DETAILED DESCRIPTION OF ACTIVITIES
Include a detailed description of activities to be undertaken on each tenement.
This should include:
- the scale and duration of company operations,
- infrastructure requirements and intentions (power, water, transportation corridors, aerodrome and/or helipad facilities etc.).
SECTION E: NOTIFIABLE EQUIPMENT
Written permission is required to have in your possession either a firearm or explosives. Written permission is also required to possess or operate an unmanned aerial vehicle.
I require written permission for:
Possession of an unmanned aerial vehicle Operation of an unmanned aerial vehicle
Possession of a firearm
Possession of explosives
Please provide details below:
SECTION F: PERMIT PERIOD
A Resource Exploration Permit may be issued for a period of not more than 7 years. Please specify the period for which the permit is sought / Enter period sought:
SECTION G: PREVIOUS APPLICATIONS FOR A PERMIT OR DEED OF ACCESS
Has a Permit or Deed of Access been held previously by the applicant company, its parent or other subsidiaries for any tenements in the WPA? / Yes / No
Include details of the previous applications by the company, parent company and other subsidiaries.
Tenement/s / Name/s
Tenement/s / Name/s
Tenement/s / Name/s
Tenement/s / Name/s
SECTION H: DECLARATION
I declare that the information provided on this form and the Attachments is, to the best of my knowledge, true and correct at the time of application.
Company seal (if applicable)
Signature of Director and date / ✍
/ /
Full Name
Position held in company (if applicable)
Signature of Secretary/other Director and date / ✍
/ /
Full Name
Position held in company (if applicable)
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I : SUPPORTING DOCUMENTS REQUIRED FOR THIS APPLICATION / CHECKLIST
Attach a copy of all Joint Venture orFarm-in agreements (if applicable).
Note: Tenement holders are to advise Joint Venture/Farm-in partners to complete application form W001. However, if the JV or Farm-in partner has an existing Exploration Permit the W001 may not be required subject to confirmation that there have been no changes since their previous application.
Attach a copy of your company’s current public liability insurance certificate for no less than the values listed below.Please refer to Notes below for further information.
Exploration ActivityA$ 20M
MiningA$ 50M
PetroleumA$ 200M
PipelineA$ 100M
Control of WellA$ 10M
Attach a copy of your company’s Worker’s Compensation insurance certificate that complies with the requirements of the applicable worker’s compensation legislation.Please refer to Notes below for further information.
Attacha current HistoricalCompany Extract Search (from an Information Broker / ASIC Service Centre)Please note:
Defence will rely on the information contained in this application and other data obtained from the HistoricalCompany Extract Search. If the extract contains outdated information, the applicant is asked to “note up” and initial each amendment on the Extract.
Attach a copy of the company structure / organisational chart including names of senior management.
Attach a plan and/or description of all tenements in the application. This plan must include the WPA boundary and applicable internal Access Zones. A map taken from South Australian Resources Information Geoserver (SARIG) is recommended.
Evacuation Plan: When necessary, Defence will require tenements to be evacuated completely for the protection of persons, property and official secrets.
Attach a detailed evacuation plan that demonstrates your ability to cease operations and evacuate your tenement(s), applicable WPA Access Zones and/or the WPA as a whole. Also, indicate the amount of time you expect that an emergency evacuation would require.
Notes:
Insurance:- It is a requirement that insurance policies are held in the name of the Permit holder, or if held in a parent company name, the policy must state that subsidiaries are included in the coverage or some evidence that the policy includes subsidiaries.
- If Workers Compensation insurance is held outside of South Australia, confirmation is required that a cross border arrangement applies within the policy.
- On renewal of each policy an updated copy should be forwarded to this office.
Please provide any additional information in the box below
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