Transcription of Home - Roads and Waterways – Transport for NSW
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Home - Roads and Waterways – Transport for NSW
UNCLASSIFIED SENSITIVE: PERSONALNSW Driver's licence/Customer numberGiven namesSurnameAddressPostcode1 Declaration (to be completed by the club's Responsible Person) Club membership details (nominate primary club first)Model (in full - name, letters and/or numbers, variant)Plate number (if known)Engine numberVIN or chassis/frame or serial number2 Vehicle details MakeModel yearShapeVehicle typeI certify that this vehicle meets the eligibility requirements of the Historic Vehicle SchemeThe registered operator is a financial member of the WagonBusPlantTrailerPlease specifyOther3(A Safety Check report must be provided if the club is less than two years old)Registered operator details NameThe vehicle is in a safe operating Inspection report numberOr DatedaymonthyearVehicle eligibility (to be completed by the club's Responsible Person) 4 The registered operator (or applicant) is responsible for the vehicle to be suitable for safe use until the expiry date of the Safety Check report must be provided if the club is less than two years registered operator must be a member of a Transport for NSW recognised Historic Vehicle C
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