The information requested in this form is being collected for the purpose of AMSA establishing technical advisory panels
to assist it in carrying out its functions under the Navigation Act 2012
(Cth) and the Marine Safety
(Domestic Commercial Vessel) National Law Act 2012
The information provided will not be used or disclosed for another purpose unless the individual from whom it was
collected has consented to that use or disclosure or its use or disclosure is otherwise authorised by law.
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