Transcription of Replacement MSIC: Lost, Damaged , Stolen or …
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Replacement MSIC: Lost, Damaged , Stolen or …
Replacement MSIC: Lost, Damaged , Stolen or Change of Type Form Application Identification Number ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ (Issuing Body Use Only) Veritas MSIC Conditions of Use: You must keep your MSIC in a safe and secure location whilst not in use. You must not alter or deface your MSIC. Your MSIC is not transferable and can only be used by you. You must return your blue MSIC within 30 days to the issuing body when: it expires; it is cancelled; it has been Damaged , altered or defaced; or you no longer have an operational need If your MSIC is lost or Stolen , you will need to provide a statutory declaration or police report or other information issued by the police before a Replacement card can be issued by an issuing body. You will have committed an offence if your MSIC is lost, Stolen or destroyed and you do not advise your issuing body within 7 days. Form Instructions: Please complete this form starting at Part A. Once all information is completed, you may email the forms to us at or post it to us at PO Box 7696, Cloisters Square WA 6850 with any supporting documents.
Commonwealth of Australia STATUTORY DECLARATION Statutory Declarations Act 1959 1 Insert the name, address and occupation of person making the declaration
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