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To get your company extract, search for your company on the ASIC Connect website.

\n\n

You will need to purchase a copy of your current company information and upload it to this form.

\n\n

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Reference code
\n\n

{{data.isCollab?\"\":\"When you saved your form you should have been provided a reference code.\"}}

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Security question
\n\n

Your answer to this question must match the information you previously provided.

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Security Question
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Next steps

\n

You are required to complete these additional forms to finalize your request.

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\n
\n

Your reference code is:

\n\n

{{Form.data.SFMData.SystemProfile.TrackingCode}}

\n\n

Please note that your saved form will expire on {{data.expiryDate}}.

\n
\n
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Send yourself a reminder email

\n

Enter your email address and we'll send you you instructions on how to return to your form.

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Check your email

\n\n

We've sent instructions to your email address ({{Form.data.$submitResponse.emailSentTo ? Form.data.$submitResponse.emailSentTo : Form.data.send_reminder_email}}) on how to return to the application when you are ready.

\n\n

If you didn't receive it or would like a reminder sent to a different email address, just click the link below and follow the instructions.

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OR

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Next steps

\n

You are required to complete these additional forms to finalize your request.

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\n
\n

Your reference code is:

\n\n

{{Form.data.SFMData.SystemProfile.TrackingCode}}

\n\n

Please quote your reference code when enquiring about your submission.

\n
\n\n
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For your records

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OR

\n\n

Send yourself an email with a PDF copy of your form

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Check your email

\n\n

We've sent a copy of your submission to {{Form.data.$submitResponse.emailSentTo ? Form.data.$submitResponse.emailSentTo : Form.data.yourEmailAddress}}.

\n\n

If you didn't receive it or would like another copy, just select the option below.

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This application will not be processed until payment is received in full.

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Health and Community Services Directorate
\nABN: 88 407 290 295

\n\n

To: {{data.calcOwner}}

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GST is not applicable under section 81-5 of the A New Tax System (Goods and Services Tax) Act 1999.

\n\n

Please transfer the fee payable to:

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Locked Bag 5005
\nWESTON CREEK  ACT  2611

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{{data.agencyName}}

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Locked Bag 5005
\nWESTON CREEK  ACT  2611

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We need a copy of your company extract that has been issued by the Australian Securities and Investment Commission (ASIC) within the last 30 days to process your application.
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\nUploading the wrong document will delay your application.
\n
\nHow do I get a current company extract?

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"repeatingData": false, "span": { "lg": 12, "md": 12, "sm": 12, "xs": 12 }, "type": "checkbox-custom" } ] ], "span": { "lg": 12, "md": 12, "sm": 12, "xs": 12 }, "type": "template-custom-page" } ], [ { "_component": "", "clearHidden": "", "entityPath": "", "exclude": false, "excludeRowData": false, "htmlLabel": "Fees", "id": "fees", "insightsName": "", "jsFiles": [], "label": "Fees", "mandatory": false, "offset": { "lg": 0, "md": 0, "sm": 0, "xs": 0 }, "overrideParentUsRule": false, "path": "Fees", "pathContext": "", "properties": { "additionalText": "Fields marked with * are required", "forcePageBreak": false, "formName": "{{T[Form.view.id].label}}", "helpText": "", "hideHeader": false, "menuText": "", "navAriaLabel": "Secondary wizard status", "offMenu": false, "sectionHeading": "{{T[item.id].label}}" }, "repeatingData": false, "rows": [ [ { "_component": "", "clearHidden": "", "entityPath": "", "exclude": false, "excludeRowData": false, "htmlLabel": "Do you wish to apply for a fee 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To claim exemption from payment of a fee you need to provide evidence of your exemption status. The evidence needed to establish exemption from payment of fees will vary depending on the type of organisation.

For charities, evidence of registration as a charity with the Australian Charities and Not-for-Profits Commission (the ACNC) is preferred.

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The annual fee for a Infection Control Activity Licence is ${{data.baseFee}} per premises, including a non-refundable portion (${{data.nonRefundableString}}) included to cover the costs associated with the processing and administration of the application.

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The fee payable is calculated as ${{data.nonRefundableFee}} + (${{data.baseFee}} - {{data.nonRefundableFee}}) × ({{data.daysEvent}} days ÷ 365 days) = ${{data.feeDue}}

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Please transfer ${{data.feeDueString}} to:

\n\n

Account name: Access Canberra
\nBSB: 037-866
\nAccount number: {{data.paymentReference}}
\nDescription: {{data.paymentDescription}}

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Locked Bag 5005
\nWESTON CREEK  ACT  2611

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Locked Bag 5005
\nWESTON CREEK  ACT  2611

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\nABN: 88 407 290 295

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We need a copy of your company extract that has been issued by the Australian Securities and Investment Commission (ASIC) within the last 30 days to process your application.
\n
\nUploading the wrong document will delay your application.
\n
\nHow do I get a current company extract?

\n", "label": "We need a copy of your company extractthat has been issued by the Australian Securities and Investment Commission (ASIC)within the last 30 days to process your application.\n\nUploading the wrong document will delay your application.\n\nHow do I get a current company extract?", "mandatoryMsg": "" }, "helpTextBlock": { "htmlLabel": "

A licence is issued to the applicant for the business, who is the person(s) who will have overall responsibility for the business including any contraventions of the Public Health Act 1997. Accordingly:

\n\n\n", "label": "A licence is issued to the applicant for the business, who is the person(s) who will have overall responsibility for the business including any contraventions of the Public Health Act 1997. Accordingly:\n\n\n\tTrusts will not be registered. Companies operating as trustees for a trust will be registered, in the Company name only.\n\tApplications listing a partnership as the owner will not be accepted. If your business is operated by a partnership, one or more of the individuals in the partnership will need to be listed.", "mandatoryMsg": "" }, "helpTextBlock_1": { "htmlLabel": "

To claim exemption from payment of a fee you need to provide evidence of your exemption status. The evidence needed to establish exemption from payment of fees will vary depending on the type of organisation.

For charities, evidence of registration as a charity with the Australian Charities and Not-for-Profits Commission (the ACNC) is preferred.

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Please note that some infection control activities cannot be offered as a mobile service. Contact the Health Protection Service for details.

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Next steps

\n

You are required to complete these additional forms to finalize your request.

", "label": "Next steps\nYou are required to complete these additional forms to finalize your request.", "mandatoryMsg": "" }, "htmlDisplay_1": { "htmlLabel": "
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Your reference code is:

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OR

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Send yourself an email with a PDF copy of your form

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OR

", "label": "OR", "mandatoryMsg": "" }, "htmlDisplay_4": { "htmlLabel": "

Next steps

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You are required to complete these additional forms to finalize your request.

", "label": "Next steps\nYou are required to complete these additional forms to finalize your request.", "mandatoryMsg": "" }, "htmlDisplay_5": { "htmlLabel": "
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Your reference code is:

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OR

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"ownershipTypeBlock": { "htmlLabel": "Ownership type", "label": "Ownership type", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "page": { "htmlLabel": "Payment invoice", "label": "Payment invoice", "mandatoryMsg": "", "properties": { "additionalText": "Fields marked with * are required", "formName": "{{T[Form.view.id].label}}", "helpText": "", "menuText": "", "navAriaLabel": "Secondary wizard status", "sectionHeading": "{{T[item.id].label}}" } }, "pageTitleRow": { "htmlLabel": "Page title row", "label": "pageTitleRow", "mandatoryMsg": "", "properties": { "formName": "{{T[Form.view.id].label}}", "subtitle": "" } }, "pageTitleRowPayment": { "htmlLabel": "Page Title Row Payment", "label": "Page Title Row Payment", "mandatoryMsg": "", "properties": { "formName": "{{T[Form.view.id].label}}", "subtitle": "" } }, "pageTitleRow_1": { "htmlLabel": "Page title row", "label": "pageTitleRow", "mandatoryMsg": "", "properties": { "formName": "{{T[Form.view.id].label}}", "subtitle": "" } }, "pageTitleRow_2": { "htmlLabel": "Page title row", "label": "pageTitleRow", "mandatoryMsg": "", "properties": { "formName": "{{T[Form.view.id].label}}", "subtitle": "" } }, "payment": { "htmlLabel": "Payment", "label": "Payment", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "paymentDescription": { "htmlLabel": "Payment Description", "label": "Payment Description", "mandatoryMsg": "" }, "paymentInstructions": { "htmlLabel": "Payment Instructions", "label": "Payment Instructions", "mandatoryMsg": "" }, "paymentOption": { "htmlLabel": "How would you like to pay?", "label": "How would you like to pay?", "mandatoryMsg": "", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "helpText": "", "options": [ { "label": "Credit card (Visa or Mastercard)", "value": "cc" }, { "label": "Bank account transfer (EFT)", "value": "eft" } ], "underHelpText": "" } }, "paymentReceiptNumber_1": { "htmlLabel": "Payment receipt number", "label": "Payment receipt number", "mandatoryMsg": "", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "helpText": "", "placeholder": "", "underHelpText": "" } }, "paymentReference": { "htmlLabel": "Payment Reference", "label": "Payment Reference", "mandatoryMsg": "" }, "paymentRule": { "htmlLabel": "", "label": "Payment Rule", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "paymentTotal": { "htmlLabel": "To be paid by credit card", "label": "To be paid by credit card", "mandatoryMsg": "", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "helpText": "", "placeholder": "", "underHelpText": "" } }, "paymentType": { "htmlLabel": "Payment Type", "label": "Payment Type", "mandatoryMsg": "" }, "paymentdetails": { "htmlLabel": "PaymentDetails", "label": "PaymentDetails", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "paymentitems": { "htmlLabel": "Paymentitems", "label": "Paymentitems", "mandatoryMsg": "", "properties": { "addItemLabel": "Add 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Phone: {{data.agencyPhone}}
\n{{data.agencyEmail}}

\n", "label": "Phone:", "mandatoryMsg": "" }, "phoneXxXxxxXxxx_3": { "htmlLabel": "

Phone: {{data.agencyPhone}}
\n{{data.agencyEmail}} 

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"htmlLabel": "Postcode", "label": "Postcode", "mandatoryMsg": "", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "helpText": "", "placeholder": "", "underHelpText": "" } }, "postalCode_7": { "htmlLabel": "Postcode", "label": "Postcode", "mandatoryMsg": "", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "helpText": "", "placeholder": "", "underHelpText": "" } }, "postalCode_8": { "htmlLabel": "Postcode", "label": "Postcode", "mandatoryMsg": "", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "helpText": "", "placeholder": "", "underHelpText": "" } }, "postalCode_9": { "htmlLabel": "Postcode", "label": "Postcode", "mandatoryMsg": "", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "helpText": "", "placeholder": "", "underHelpText": "" } }, "postcodeBlk": { "htmlLabel": "PostCode", "label": "PostCode", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "postcodeBlk_1": { "htmlLabel": 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{ "ariaLabel": "" } }, "repeatedHeader": { "htmlLabel": "Repeated Header", "label": "Repeated Header", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "repeatedHeaderIndex_1": { "htmlLabel": "

{{Form.getItemProperty(\"data.rptOwner\",\"itemLabel\")}} {{$index+1}}

", "label": "", "mandatoryMsg": "" }, "reprocessed": { "htmlLabel": "Reprocessed", "label": "Reprocessed", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "residentialAddress": { "htmlLabel": "Residential address", "label": "Residential address", "mandatoryMsg": "", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "helpText": "", "placeholder": "", "underHelpText": "" } }, "resources": { "htmlLabel": "resources", "label": "resources", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "returnToForm": { "htmlLabel": "Click here to return to your form", "label": "Click here to return to your form", "mandatoryMsg": "", "properties": { "fontawesome": "fa-face-laugh" } }, "returnToPortal_1": { "htmlLabel": "Return to portal", "label": "Return to portal", "mandatoryMsg": "", "properties": { "fontawesome": "fa-face-laugh" } }, "returnToPortal_2": { "htmlLabel": "Return to portal", "label": "Return to portal", "mandatoryMsg": "", "properties": { "fontawesome": "fa-face-laugh" } }, "rptOwner": { "htmlLabel": "Rpt Owner", "label": "Rpt Owner", "mandatoryMsg": "", "properties": { "addItemLabel": "Add {{item.properties.itemLabel}}", "itemLabel": "Owner" } }, "ruleDone": { "htmlLabel": "Rule Done", "label": "Rule Done", "mandatoryMsg": "" }, "saveAndClose": { "htmlLabel": "Save and close", "label": "Save and close", "mandatoryMsg": "", "properties": { "fontawesome": "fa-face-laugh" } }, "saveComponent": { "htmlLabel": "Save Component", "label": "Save Success Component", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "saveConfirm": { "htmlLabel": "Confirm", "label": "Confirm", "mandatoryMsg": "", "properties": { "fontawesome": "fa-face-laugh" } }, "saveConfirm_1": { "htmlLabel": "Confirm", "label": "Confirm", "mandatoryMsg": "", "properties": { "fontawesome": "fa-face-laugh" } }, "saveYourForm": { "htmlLabel": "Save confirmation", "label": "Save confirmation", "mandatoryMsg": "" }, "save_challenge_question_section": { "htmlLabel": "Section", "label": "Section", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "save_challenge_reference_code": { "htmlLabel": "Reference code", "label": "Reference code", "mandatoryMsg": "", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "helpText": "", "placeholder": "", "underHelpText": "" } }, "save_success_send_reminder": { "htmlLabel": "Send now", "label": "Send now", "mandatoryMsg": "", "properties": { "fontawesome": "fa-face-laugh" } }, "savechallenge": { "htmlLabel": "Save challenge", "label": "Save challenge", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "saveconfirm": { "htmlLabel": "Save confirm", "label": "Save confirm", "mandatoryMsg": "", "properties": { "ariaLabel": "" } }, "savesuccess": { "htmlLabel": "savesuccess", "label": "savesuccess", "mandatoryMsg": "", "properties": { "alertMsg": "", "leavePageWarningMessage": "", "linkWarningMsg": "opens in a new window", "mandatoryMsgSuffix": "is required", "progressMsg": "Please wait..." } }, "secondaryType": { "htmlLabel": "What is your secondary infection control activity type?", "label": "What is your secondary infection control activity type?", "mandatoryMsg": "", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "helpText": "", "options": [ { "label": "Acupuncture", "value": "Acupuncture" }, { "label": "Beauty therapy", "value": "Beauty therapy" }, { "label": "Beauty therapy including cosmetic tattooing", "value": "Beauty therapy including cosmetic tattooing" }, { "label": "Blood donation service", "value": "Blood donation service" }, { "label": "Body piercing", "value": "Body piercing" }, { "label": "Colon hydrotherapy", "value": "Colon hydrotherapy" }, { "label": "Cosmetic skin clinic", "value": "Cosmetic skin clinic" }, { "label": "Dental practice", "value": "Dental practice" }, { "label": "Dry needling", "value": "Dry needling" }, { "label": "Facial waxing", "value": "Facial waxing" }, { "label": "Nail 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The fee payable is calculated as ${{data.nonRefundableFee}} + (${{data.baseFee}} - {{data.nonRefundableFee}}) × ({{data.daysEvent}} days ÷ 365 days) = ${{data.feeDue}}

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Security Question
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To get your company extract, search for your company on the ASIC Connect website.

\n\n

You will need to purchase a copy of your current company information and upload it to this form.

\n\n

ASIC charges a fee for your company extract. The free company summary does not have the required information to process your application.

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This application will not be processed until payment is received in full.

\n\n

Health and Community Services Directorate
\nABN: 88 407 290 295

\n\n

To: {{data.calcOwner}}

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GST is not applicable under section 81-5 of the A New Tax System (Goods and Services Tax) Act 1999.

\n\n

Please transfer the fee payable to:

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Please transfer ${{data.feeDueString}} to:

\n\n

Account name: Access Canberra
\nBSB: 037-866
\nAccount number: {{data.paymentReference}}
\nDescription: {{data.paymentDescription}}

\n", "label": "Please transfer $to:\n\nAccount name:Access Canberra\nBSB:037-866\nAccount number:\nDescription:", "mandatoryMsg": "" }, "textDisplay_2": { "htmlLabel": "

For your records

", "label": "For your records", "mandatoryMsg": "" }, "textDisplay_3": { "htmlLabel": "abouttext", "label": "abouttext", "mandatoryMsg": "" }, "textDisplay_4": { "htmlLabel": "

Send yourself a reminder email

\n

Enter your email address and we'll send you you instructions on how to return to your form.

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Check your email

\n\n

We've sent instructions to your email address ({{Form.data.$submitResponse.emailSentTo ? Form.data.$submitResponse.emailSentTo : Form.data.send_reminder_email}}) on how to return to the application when you are ready.

\n\n

If you didn't receive it or would like a reminder sent to a different email address, just click the link below and follow the instructions.

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Reference code
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{{data.isCollab?\"\":\"When you saved your form you should have been provided a reference code.\"}}

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Security question
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Your answer to this question must match the information you previously provided.

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Check your email

\n\n

We've sent a copy of your submission to {{Form.data.$submitResponse.emailSentTo ? Form.data.$submitResponse.emailSentTo : Form.data.yourEmailAddress}}.

\n\n

If you didn't receive it or would like another copy, just select the option below.

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Please keep a copy of this receipt for your records.", "label": "Your submission has been successful. Please keep a copy of this receipt for your records.", "mandatoryMsg": "" } }, "label": "English" } ] }, "type": "form" }