Australian Government - Australian Maritime Safety Authority

AMSA forms

APPLICATION FOR SEA RANGERS EXEMPTION – AMSA 618
Marine Safety (Domestic Commercial Vessel) National Law Act 2012
EX14 - Marine Safety (Sea rangers) Exemption 2020
 
Guidance on when to use this form
If you are unsure of any information please leave blank.
A. Applicant details
Name (individual)
ACN (if applicable)
ABN (if applicable)
Vessel name
Unique Identifier
Vessel length (must be <7.5m long)
Vessel propulsion
B. Provision of information by applicant
  1. Is the applicant employed as a sea ranger by an Indigenous community organisation or a sea management organisation connected with an Indigenous community organisation?
  2. Describe the operation that the applicant will be involved in as master of the vessel?

C. Applicant’s declaration and consent

I declare that:
  • To the best of my knowledge the information provided by me in this application (and any attachments I have included with this application) is true and correct.
  • I consent to the Australian Maritime Safety Authority, as the National Regulator, making all reasonable enquiries in order to verify that the information provided by me in this application (and any attachments I have included with this application) is true and correct.
  • I understand and acknowledge that the Australian Maritime Safety Authority, as the National Regulator, may ask that I provide any information or document that the National Regulator reasonably considers necessary for consideration of this application.
  • I understand and acknowledge that the Australian Maritime Safety Authority, as the National Regulator, may ask another person to provide any information, document or agreement that the National Regulator reasonably considers necessary for consideration of this application.
Signature
Name
Date
Privacy Statement
The collection of information requested in this form is required or authorised by Schedule 1 of the Marine Safety (Domestic Commercial Vessel) National Law Act 2012 (the Act). It will be used for purposes related to the Act and may be provided to Commonwealth or State/Territory government agencies for the purposes of marine safety. Failure to provide the information may result in the transaction not being processed. To contact us, or for more information on how to access or correct your personal information, how to make a privacy complaint, or how your information may be used or disclosed for purposes beyond those described in this statement, visit www.amsa.gov.au/privacy.
How to lodge
You can email or post your application form to AMSA.

Email applications can be sent to: DCVapplications@amsa.gov.au

Postal applications can be addressed to:

Australian Maritime Safety Authority
Attention: AMSA Connect
GPO Box 2181
Canberra ACT 2601
Australia
 
OFFICIAL USE ONLY

D. Action by National Regulator

  1. Has the applicant signed the declaration?
  2. Is the applicant employed as a sea ranger by an Indigenous community organisation or a sea management organisation connected with an Indigenous community organisation?
  3. Has the applicant passed an assessment by the National Regulator, or an organisation approved by the National Regulator, of whether they have the operational knowledge, and knowledge of Australian maritime legislation, appropriate for the specified operation?
  4. Is the applicant able to be the master of a vessel that is less than 7.5m long and has outboard propulsion power?
  5. Is the vessel less than 7.5m long and does it have outboard propulsion power?
  6. Will the approval be granted?
    • If ‘Yes’, complete Approval Section E.
    • If ‘No’, provide reasons below.
E. Approval
I hereby grant approval under the Marine Safety (Sea ranger) Exemption 2020 to the applicant listed below, to carry out the specified operation, as master, of a domestic commercial vessel in the specified area for purposes associated with managing activities within the marine environment without the requirement to hold a certificate of competency that would otherwise be required for the intended operation, subject to conditions of the exemption (if any) and the conditions below.

Applicant name

Conditions imposed
Specified area
Effective from
Effective to (Must be no later than 30 June 2025)
Delegate of the National Regulator
Signature
Date
AMSA form: 618
Version: 1 7/18