Vehicle Suitable for Safe Use Declaration

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Year of manufactureNSW Driver licence/Customer number1Registered operator details 2Catalogue Form No. 1245 (10/2016) Vehicle Suitable for safe Use DeclarationVehicle identificationPlate number (if known) Vehicle useRecreationEarthwork/ RoadworkFarm3ForestryMiningOther (please specify)9Privacy statement and declarationI declare that:a)the Vehicle has the equipment and fittings marked on this form and are in operating )I will be responsible for the Vehicle to be Suitable for safe use until the expiry of the registration or )daymonthyearOffice use:For non complying vehicles do equipment and fittings nominated comply with the relevant Conditional Registration Vehicle Sheet?YesIs an overmass/overdimension permit required?NoRefer to the Special Permits Unit or National Heavy Vehicle Regulator before registering the Service Representative signatureStaff number(Primary Producer Declaration required) Vehicle description (eg.

Year of manufacture. NSW Driver licence/Customer number. 1 Registered operator details 2. Catalogue No.45070938 Form No. 1245 (10/2016) Vehicle Suitable for Safe Use …

  Safe, Safe use