Ref. L7A

Radiation Protection and Nuclear Science Department

National Environment Agency

Environmental Building, 3rd Storey, Annex Block

40 Scotts Road, Singapore 228231

Email:

Website: http://www.nea.gov.sg

RADIATION PROTECTION ACT 2007
APPLICATION FOR A LICENCE TO IMPORT
IONISING RADIATION IRRADIATING APPARATUS

This form will take approximately 15 minutes to be completed. Please ensure that you are using the latest version.

Every section of the application form MUST be duly completed. “N.A.” should be used when appropriate.

Application form without the details of the irradiating apparatus, incomplete application form, or incorrect payment will result in the rejection of this application.

For payment by cheques, the accompanying cheque must be submitted together with the completed application form, failing which the form will not be processed.

1. Name of firm / organisation:
(See Note 1) / 2. Company Stamp:
3. Address:
4a. Contact Person: / 4b. Designation:
4c. NRIC / FIN No.: / 5. Email address:
6. Tel. No.: / 7. Fax. No.:
H.P. No.:
8. Licence No. covering possession: / L1/ / ______/ / / ______
or
L3/ / ______/ / / ______
9. Name and address of company who will be using the irradiating apparatus:

Company Unique Entity Number (UEN):

10. Particulars of the irradiating apparatus for which licence is sought:
Qty
/

Type / Purpose

(medical, dental, industrial) / Maker / Manufacturer /

Model

/

Specifications

(kV, mA, s/n)
11. Supplier: / 12. Means of Transport:
@Air / Sea / Land
13. Country of Shipment: / 14. Arrival Date:

@ Delete as appropriate

15. Mode of payment* (Check with your Finance Department before completing this section – Please Tick One Only):

Payment by GIRO (Your company must have a RPNSD Giro Account)
Payment by cheque – Bank/cheque No: ______(Please refer to Notes below.)
Payment by NETS or Credit Cards at NEA Customer Service Counter

*Note: Unless specially requested, the invoice and the receipt will be sent to the company address provided at Sections 1 & 3 above. Cheques should be made payable to “National Environment Agency”. Payment by methods not specified above is liable to be rejected and will cause processing delay to your application.

Import Licence / Fees / Please Tick One
L7A / $ 40/- / ( )
16. I hereby apply for a licence to import the above consignment of irradiating apparatus and declare that all the particulars contained in this application are correct and true.
I acknowledge that any fee paid for this application is not refundable, including in the event where the application is rejected or cancelled.
The National Environment Agency (NEA) collects personal information to carry out its various functions and duties under the National Environment Agency Act (Cap 195) including the implementation of environmental and public health policies in Singapore and any other related purposes. I hereby consent to NEA’s use of the information provided by me in the course of any application I have made to the NEA, to facilitate the processing of such application for such purposes. I hereby further consentto NEA sharing the information in such application with other Government agencies, or non-government entities authorised to carry out specific government services, unless prohibited by legislation.
Name of Applicant /
Designation of Applicant
Signature of Applicant /
Date

Note:

1. The company named in section 1, which is applying for an IMPORT licence MUST be registered with an L1 or L3 licence. The L1 or L3 licences should be stated in section 8. This application must be completed and signed by the authorised officer of the company in section 1. The form cannot be signed by a forwarder on behalf of the company.

2. The company named in section 9 should be the company to whom the irradiating apparatus is to be sold or delivered after import.

3. This application should be used for consignments of ionising radiation irradiating apparatus, such as X-ray machines. For the import of radioactive materials, the L8A licence should be applied for instead. The L8A licence is also applicable for equipment containing a radioactive source, such as radiography projectors, nuclear gauges and electron mobility spectrometers.

4.  A separate application is required for each consignment. A consignment which contains both irradiating apparatus and radioactive material as separate items will require both the L7A and L8A licences.

5.  The attention of an agent importing irradiating apparatus for sale, is drawn to Section 6(2) of the Radiation Protection Act 2007 which requires that notice of every sale of irradiating apparatus to be given to the Director-General of Environmental Protection, National Environment Agency together with the name and address of the person to whom it was sold.

6. The completed application form should be submitted together with prescribed fee of $40/- to:

Head, Ionising Radiation Control Section

Radiation Protection and Nuclear Science Department

National Environment Agency

Environment Building

3rd Storey, Annex Block

40 Scotts Road, Singapore 228231

Version 1.7 / Dec 2017 3