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1 Department of Agriculture and FisheriesRegistrable biosecurity entity (RBE) applicationdesignated animalcattle, buffalo, bison, sheep, goat , pig, poultry, designated birds, equine, deer, camel, alpacas, llamasPursuant to Chapter 7 of the Biosecurity Act 2014 OFFICE USE ONLYP urpose of this form This form is to be used for initial registration of a registrable biosecurity entity or to register an additional/new location where designated animals are kept. An individual, partnership, organisation or other entity that owns or keeps the specified number of designated animals, must apply to the Department of Agriculture and Fisheries to register as a biosecurity entity. You may already be registered (automatically) If you were allocated a Property Identification Code (PIC) before 1 July 2016, you will have been registered as a biosecurity entity.

2 If you are unsure if you are registered, please contact the Customer Service Centre on 13 25 23. How to submit this form In person to: A Department of Agriculture and Fisheries regional office (not all offices can accept payment); or Via post to: RBE Processing Department of Agriculture and Fisheries PO Box 1329 Toowoomba Qld 4350 prescribed fee For the current applicable fee, please visit If applicable, the prescribed fee must be paid on submission of the application. Term of registration Registration is valid for three (3) years from the date you apply. Notification You will be notified of the outcome of your application within ten (10) working days after submission, provided all the required information has been received.

3 Notification will be by email ifyou provide an email address, and by post otherwise. Please note that correspondence for all registered entities will go to the single nominated RBE contact address. Designated animals per location If you keep designated animals in multiple locations you must complete sections B & C for each location. Contact us For more information please contact or the Department of Agriculture and Fisheries Customer Service Centre on 13 25 23. BQ/2017/2676 BQRBE02 v5 - Reviewed May 2020 1/8BY COUNTER STAFF PAYMENT DETAILSDATE APPLICATION RECEIVED:FEE PAYABLE: Payable ExemptIf payableFee due: $FINANCIAL OFFICER PROCESSING PAYMENT:PAYMENT AMOUNT RECEIVED AND RECEIPTED IN SAP:PAYMENT METHOD: (credit/debit card, cash, cheque, money order)DATE RECEIPTED IN SAP:SAP RECEIPT NUMBER:RECEIPT REQUIRED: Yes NoIf Yes - by email by postBY OFFICER PROCESSING THE APPLICATIONPROCESSING OFFICER:LOT ON PLAN DETAILS PROVIDED: Yes NoRBE NUMBER:PIC NUMBER:FURTHER INFORMATION REQUEST DATE:DATE FURTHER INFORMATION RECEIVED:If you were allocated a PIC before 1 July 2 Part A - Applicant details1.

4 Applicant type Select one only complete entire form Register for the first time biosecurity entity. You are not required to a0p1p6ly, .you will have been registered as a complete parts A-D Register an additional location or update your details to an RBE Please supply RBE numberApplicant is a Select one only complete section 2, skip section 3 Private individual/s skip section 2, complete section 3 Company Government organisation Trust Registered body2. Private individual/sDetails of all individuals to be registered must be included. If there are more than two individuals, attach supplementary pages andprovide the same information as below for each additional 1 Applicant 2 Provide all given names in full no initials Provide all given names in full no initialsGiven name/sSurnamePreferred nameOnly complete residential address for applicant 2 if different fromMust be a road or street name - cannot be a PO Boxapplicant 1 Residential addressLocality/suburbStatePostcodePostc odeCountryRBE contact address Make this address the main contact address Make this address the main contact address(select only once in thisapplication)

5 Only complete postal address for applicant 2 if different fromOnly complete if different from residential addressapplicant 1 Postal addressLocality/suburbStatePostcodePostc odeCountryRBE contact address Make this address the main contact address Make this address the main contact address(select only once in thisapplication)Provide at least one phone number other than fax Only complete if different from applicant 1 PhoneMobileFaxEmailIndicate if applicant 1 is the land owner of the land where theIndicate if applicant 2 is the land owner of the land where the animalsanimals are keptare keptLand owner Yes No Yes NoIndicate if applicant 1 is the occupier of the land where the animalsIndicate if applicant 2 is the occupierare keptOccupierThe occupier is the person Yes No Yes Nowho is in control of the day today operations of the BQRBE02 v5 - Reviewed May 2020 2/83.

6 Company, trust, registered body or government organisationIf applicant is a company, trust, registered body or government organisation ( not a private individual) please complete the , trust, registered body or government organisationOrganisation nameIs the organisation Yes Nothe land owner?Must have a road or street number and name cannot be a PO BoxBusiness addressLocality/suburbStatePostcodeCount ryRBE contact Make this address the main contact addressaddress(select only once in thisapplication)Only complete postal address if different from business addressPostal addressLocality/suburbStatePostcodeCount ryRBE contact Make this address the main contact addressaddress(select only once in thisapplication)Contact personDetails of organisation contact person must be provided - Provide all given names in full no initialsGiven name/sSurnamePreferred nameIs the organisation Yes Nocontact person theoccupier?

7 Provide at least one phone number other than faxPhoneFaxMobileEmail4. Additional details for the registrable biosecurity entityOnly complete if nameAustralian BusinessNumberBQ/2017/2676 BQRBE02 v5 - Reviewed May 2020 3/8 Part B - Designated animals detailsIf you need to include more than one location where animals are kept in this application, please complete another form (parts B & Conly) and attach it to this note that you may include a main site address and an additional site address where animals are Designated animal typePlease indicate which type of designated animals you are keeping, estimated number, and for which purpose, per location. Thedefinition of designated animals and the minimum threshold to keep can be found on the Department s Designated animal biosecurity riskAre you aware of any biosecurity risk in relation to the animals being kept ( cattle tick in cattle tick free zone, organochlorine orlead status restriction on an animal)?

8 No Yes If yes, you MUST provide details in the space provided below. (If additional space is required please attach as separate pages.)BQ/2017/2676 BQRBE02 v5 - Reviewed May 2020 4/8 SpeciesEstimatednumberProduction typeEnterprise type Cattle Dairy Meat Abattoir Feedlot GrazingHolding facility Buffalo, bison Dairy Meat Abattoir Feedlot GrazingHolding facility Sheep Dairy Fibre Meat Abattoir Feedlot GrazingHolding facility Goats Dairy Fibre Meat Abattoir Feedlot GrazingHolding facility Pigs Meat Abattoir Free range Intensive Poultry Egg Meat Abattoir Free range Intensive Other designated birds( emu, ostrich, pigeon) Egg Meat Free range Intensive Equine (horse, pony, donkey, mule, zebra)

9 Commercial Non-commercial Abattoir grazing Deer Meat Abattoir grazing Camels Dairy Fibre Meat grazing Alpacas, llamas Dairy Fibre Meat GrazingPart C - Location where animals are kept1. Primary site address of the propertyProperty name for the primary site addressStreet or road address for the primary site address must be a street or road address, not PO number Road/street nameSuburb/Town/Locality Country State PostcodeAustralia Queensland2. Holding facilityOnly complete this section, if this location is a holding facility. Select one onlyType of holding facility: Depot Dip yard Export facility Saleyard Showground Transit centre3. Property lot/s on plan/s (refer to property rates notice, land valuation notice or property title) If more than one lot on plan, the first lot on plan listed will be considered the MAIN lot on plan.

10 If the lot on plan is or was attached to a PIC and you know the PIC, please indicate it. If the property has more than seven (7) lots on plan, attach additional numberPlan numberLocal government areaPIC if knownExample: 103RP15678 BrisbaneQBN123454. Additional address for the property (if applicable)Street or road address must be a street or road address, not PO the property name for this additional site address (if applicable)Lot/street number Road/street nameSuburb/Town/Locality Country State PostcodeAustralia Queensland5. Biosecurity riskIf you are aware of any biosecurity risk at the properties where the animals are being kept ( organochlorine residues or heavymetal contamination) you MUST provide details Yes If yes, you MUST provide details in the space provided below.