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\nABN: 88 407 290 295
To: {{data.calcOwner}}
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\n\nPlease transfer the fee payable to:
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Please keep a copy of this receipt for your records.", "id": "yourSubmissionHasBeenSuccessful_2", "insightsName": "", "jsFiles": [], "label": "Your submission has been successful. Please keep a copy of this receipt for your records.", "mandatory": false, "noData": true, "offset": { "lg": 0, "md": 0, "sm": 0, "xs": 0 }, "overrideParentUsRule": false, "path": "", "pathContext": "", "properties": { "floatRight": false }, "repeatingData": false, "span": { "lg": 12, "md": 12, "sm": 12, "xs": 12 }, "type": "text-display-custom" } ], [ { "_component": "submissionConfirmation", "clearHidden": "", "entityPath": "", "exclude": false, "excludeRowData": false, "htmlLabel": "Date and time", "id": "dateAndTime_2", "insightsName": "", "jsFiles": [], "label": "Date and time", "mandatory": false, "offset": { "lg": 0, "md": 0, "sm": 0, "xs": 0 }, "overrideParentUsRule": false, "path": "SFMData/SystemProfile/SubmitDateString", "pathContext": "abs", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "floatRight": false, "helpText": "", "hideLabel": false, "inputMode": "text", "inputType": "text", "leftLabel": false, "maxLength": "", "nowrapLabel": false, "placeholder": "", "preventCopyPaste": false, "underHelpText": "" }, "repeatingData": false, "span": { "lg": 4, "md": 4, "sm": 4, "xs": 4 }, "type": "text-input-custom" }, { "_component": "submissionConfirmation", "clearHidden": "", "entityPath": "", "exclude": false, "excludeRowData": false, "htmlLabel": "Reference code", "id": "referenceCode_2", "insightsName": "", "jsFiles": [], "label": "Reference code", "mandatory": false, "offset": { "lg": 0, "md": 0, "sm": 0, "xs": 0 }, "overrideParentUsRule": false, "path": "SFMData/SystemProfile/TrackingCode", "pathContext": "abs", "properties": { "alertIcon": "fa-solid fa-face-laugh", "alertText": "", "floatRight": false, "helpText": "", "hideLabel": false, "inputMode": "text", "inputType": "text", "leftLabel": false, "maxLength": "", "nowrapLabel": false, "placeholder": "", "preventCopyPaste": false, "underHelpText": "" }, "repeatingData": false, "span": { "lg": 3, "md": 3, "sm": 3, "xs": 3 }, "type": "text-input-custom" } ], [ { "_component": "submissionConfirmation", "clearHidden": "", "entityPath": "", "exclude": false, "excludeRowData": false, "htmlLabel": "{{data.followupdata}}", "id": "textdisplay1_2", "insightsName": "", "jsFiles": [], "label": "", "mandatory": false, "noData": true, "offset": { "lg": 0, "md": 0, "sm": 0, "xs": 0 }, "overrideParentUsRule": false, "path": "", "pathContext": "", "properties": { "floatRight": false }, "repeatingData": false, "span": { "lg": 12, "md": 12, "sm": 12, "xs": 12 }, "type": "text-display-custom" } ], [ { "_component": "submissionConfirmation", "clearHidden": "", "entityPath": "", "exclude": false, "excludeRowData": false, "htmlLabel": "ReceiptFooter", "id": "receiptfooter_2", "insightsName": "", "jsFiles": [], "label": "ReceiptFooter", "mandatory": false, "noData": true, "offset": { "lg": 0, "md": 0, "sm": 0, "xs": 0 }, "overrideParentUsRule": false, "path": "", "pathContext": "", "properties": { "ariaHidden": false, "ariaLabel": "" }, "repeatingData": false, "rows": [ [ { "_component": "submissionConfirmation", "clearHidden": "", "entityPath": "", "exclude": false, "excludeRowData": false, "htmlLabel": "{{data.agencyName}}
\n", "id": "agency_1", "insightsName": "", "jsFiles": [], "label": "", "mandatory": false, "noData": true, "offset": { "lg": 0, "md": 0, "sm": 0, "xs": 0 }, "overrideParentUsRule": false, "path": "", "pathContext": "", "properties": {}, "repeatingData": false, "span": { "lg": 4, "md": 4, "sm": 4, "xs": 4 }, "type": "html-display" }, { "_component": "submissionConfirmation", "clearHidden": "", "entityPath": "", "exclude": false, "excludeRowData": false, "htmlLabel": "Locked Bag 5005
\nWESTON CREEK ACT 2611
Phone: {{data.agencyPhone}}
\n{{data.agencyEmail}}
{{data.agencyName}}
\nABN: 88 407 290 295
Locked Bag 5005
\nWESTON CREEK ACT 2611
Phone: {{data.agencyPhone}}
\n{{data.agencyEmail}}
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?
The person responsible for naloxone program compliance.
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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.
\n
\nUploading the wrong document will delay your application.
\n
\nHow do I get a current company extract?
The person responsible for naloxone program compliance.
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\n\nPlease note that your saved form will expire on {{data.expiryDate}}.
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