Official number	Ship’s name

Home port

Present home port

The presently approved home ports are: NSW: Sydney, Newcastle, Port Kembla, Yamba, Jervis Bay, Lake Macquarie, Port Stephens. VIC: Melbourne, Geelong, Portland. QLD: Abell Point, Brisbane, Bundaberg, Cairns, Gladstone, Hamilton Is., Hayman Is., Karumba, Mackay, Maryborough, Mooloolaba, Mourilyan, Port Douglas, Rockhampton, Southport, Townsville. Rosslyn Bay SA: Port Adelaide, Kingston, Goolwa, Wallaroo. Port Lincoln WA: Broome, Fremantle, Dampier, Port Hedland. TAS: Hobart, Burnie, Devonport, Launceston. NT: Darwin, Gove Harbour.
Proposed home port

*Full name and address of owner(s)

*Contact telephone number	*Email address (if any)

Signature

I hereby apply for approval to change the home port of the ship described above.

Date	Place

Signature of registered agent	Signature of witness
If the applicant is a corporation, the document may be formally executed under the corporate seal. Alternatively, an officer of the corporation may sign it, endorse it with a legible statement of his/her name and designation and have the signature witnessed.
Name of witness
Address of witness

NOTE

Please forward certificate of registration along with the application for change of home port.

Except where indicated by * the collection of information requested in this form is either required or authorised by the Shipping Registration Act 1981 (the Act). It will be used for purposes related to the Act (including possible overseas disclosure) and will be available for public search in circumstances as the Act requires. It may be made available to government agencies for statistical and administrative purposes. Failure to provide the information will result in the transaction not being processed. To contact us, or for more information on how to access or correct your personal information or how to make a privacy complaint, visit www.amsa.gov.au/privacy-policy