Application for OrchardApprovalforPersimmons toThailand – Queensland only

(Only one application per form)

ORCHARDNAME

PROPERTY ADDRESS

CONTACT DETAILS

State:
Postcode:
Name:
E-mail address:
Ph: ( )
Postal/Business
address
State: / Postcode:
Nominated packhouse: / Department Reg. Est. No:
Nominated packhouse: / Department Reg. Est. No:
Nominated packhouse: / Department Reg. Est. No:
DECLARATION
By applying for export under the protocol, I/we, (must be a person, not a declaration from the trading name of the entitiy)...... agree to the following:
  • To meet the conditions and requirements that apply to the export of Australian persimmon fruit to Thailand.
  • To undertake regular and routine management, to ensure that quarantine pests of concern to protocol markets are adequately managed;
  • The Department of Agriculture and Water Resources Privacy Notice (attached).
Failure to comply with the aforementioned conditions and restrictions, including but not limited to providing access to properties and documents required under the above agreements, may lead to importing country requirements not being met or not being verified which will prevent certification being issued.
ADDRESS FOR SUBMITTING APPLICATION:

By signing this application I acknowledge I have read the relevant Protocol for the nominated market and agree to meet the conditions and requirements contained therein.

ORCHARD
REPRESENTATIVE
(Print name) / SIGNATURE / DATE
WITNESS
(Print name) / SIGNATURE / DATE

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Orchard Name: / Office Use Only
Block Location (Address or Geographic Coordinates) / Block Number/Name (as Identified on Map) / Area (Hectares) / Export Listed Block Number

BLOCK/MAP DETAILS:

It is mandatory that a map of the property be provided with block details. It is a requirement that the grower be able to identify exactly the physical location of the export listed orchard. The grower must be able to clearly distinguish the block(s) identified for export listing. There must be a detailed map of the orchard with clear delineation of the export listed block(s), both on the map provided and on-site.

Maps provided must include key information (i.e. road names) to identify the property through a searchable computer-based mapping program (eg. Google maps). Maps may not be hand-drawn.

A single block must not span across any significant physical barriers – ie roads, ridges etc.

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Privacy Notice Horticulture Exports Program

‘Personal information’ means any information or opinion about an identified, or reasonably identifiable, individual.

The collection of personal information by the Department of Agriculture (the department) in relation to this application is for the purpose of export listing, meeting requirements under nominated importing country protocols, to assist in the collection of industry levies, and related purposes. If the relevant personal information requested in this application form is not provided by you, the department will be unable to assess your eligibility to export your commodity to importing countries.

Personal information may be disclosed to Australian Diplomatic Posts, and relevant Industry Peak Bodies, persons or organisations where necessary for these purposes, provided the disclosure is consistent with relevant laws, in particular the Privacy Act 1988. Your personal information will be used and stored in accordance with the Privacy Principles.

By completing and submitting this form you consent to the disclosure of all personal information contained in this form to the National Plant Protection Organisation (NPPO) of the nominated importing countries. The department has not taken steps to ensure that the NPPO of importing countries does not breach the Privacy Principles. This means that:

  • the NPPO will not be accountable under the Privacy Act
  • you will not be able to seek redress under the Privacy Act
  • you may not be able to seek redress in the overseas jurisdiction.

NPPO of importing countries may not be subject to any privacy obligations or to any principles similar to the Privacy Principles.

The department’s Privacy Policy, including information about access to and correction of your personal information, can be found at:

To contact the department about your personal information or to make a complaint:

Telephone: Switchboard +6126272 3933

Email:
Post: Privacy Contact Officer, Department of Agriculture and Water Resources
GPO Box 858
Canberra ACT 2601

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