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1 Declaration of Eligibility for a Registration Concession Please tick the appropriate registration concession box then sign the declaration on page 2. Light vehicles up to tonnes Gross Vehicle Mass attract vehicle tax. Heavy vehicles over tonnes Gross Vehicle Mass attract registration charges. 1. Customer/Organisation details Fire Fighting Vehicle (not Fire and Rescue NSW). (FIRE). NSW Driver licence/Customer number Council-owned light vehicle - used for bush fire control, and may also be used for road maintenance repair and construction, but not for any other purpose.

2 Surname or Name of Organisation Company-owned light vehicle - used solely for and in connection with the control of bush fires. Transport for people with a disability (HAND). Light or heavy passenger vehicle used solely for the work of Given names (if applicable) conveying sick or injured (including intellectually or mobility impaired) people. Vehicles used for private use are not eligible Vehicles registered to government agencies are not Date of birth (if applicable) eligible. / / Goods vehicles are not eligible, for example utilities and trucks.

3 Day Month Year Address Mobile Crane (MCRA). Light mobile crane not let for hire. Mine Rescue Vehicle (MINE). Light or heavy vehicle used solely for mine rescue work in State Postcode accordance with the Coal Industry Act 2001. 2. Registration Plate Number Primary Producer Vehicle (PPG). See attached Light or heavy vehicle used by a primary producer or rural OR Registration Plate co-operative, but not used or let for hire, and solely or Number Schedule principally: to cart primary products the primary producer or another 3. Registration Concession Type (select appropriate) primary producer has produced Ambulance Vehicle (AMBU) to cart leaves gathered by the primary producer or another primary producer to distil and produce Light or heavy vehicle other than a government owned eucalyptus or other oils vehicle, specially constructed and solely used for carrying to cart goods of any kind for the primary producer or sick or injured persons.

4 Concession does not entitle an another primary producer's business or household operator to fit flashing lights and sirens. Only vehicles used solely by the Ambulance Service of NSW as defined under for purposes connected with clearing land that the the Health Services Act 1997 or a vehicle delegated by the primary producer or another primary producer proposes Ambulance Service of NSW under their delegated authority to use for primary production may be fitted with flashing lights and sirens. Fish farmers and plantation forest cultivators are primary producers.

5 Commercial fishers and loggers are not primary Civil Defence Vehicle (CIVL) / State Emergency producers under this legislation and are therefore not Service (SES) entitled to a primary producer registration concession You must provide one of the following documents to Light or heavy vehicle used by a civil defence group, an support your application: industrial mutual aid group or a rescue organisation solely in connection with civil defence or rescue work arising from A declaration signed by a registered tax agent or some general emergency or catastrophe such as drought, accountant, stating the applicant is a primary producer as flood, fire or similar emergency.

6 Vehicles must be defined by the Motor Vehicles Taxation Act 1988, or registered in the name of the organisation controlling the A Tax Averaging Certificate from the Australian Taxation work. Vehicles registered to government agencies, other Office (not more than two years old), or than councils are not eligible. A Tax Assessment Notice from the Australian Taxation Office (not more than two years old). Continued on page 2. Catalogue No. 45070829 Form No. 1193 (02/2021) Page 1 of 2. ABN 18 804 239 602. UNCLASSIFIED. SENSITIVE: PERSONAL. Rural Lands Protection Board Vehicle (PAST) 4.

7 Customer / Organisation Declaration Light truck or trailer used solely for the functions of Local You declare: Land Services. you are eligible for the concession you will notify us within 14 days if your concession Police Youth Club Vehicle (POLC) eligibility ceases Light vehicle owned by a Police Youth Club and used solely you understand the need to provide evidence of your for Police Youth purposes. concession eligibility when requested. If the evidence is not provided it can lead to you paying vehicle registration Roadwork by a Council, Park or Cemetery Trust charges and tax (RDWK) you understand Transport for NSW can suspend or Light vehicle owned by a Council, Park or Cemetery Trust cancel the vehicle registration for concession ineligibility and used solely for or in accordance with the.

8 Under road Transport legislation, it is an offence to attempt construction, maintenance or repair of Roads , bridges or to register or renew the registration of a vehicle by false cemeteries including supervising such work; or statement or any misrepresentation or other dishonest removal of garbage or night soil; or means. rolling or maintenance of tennis courts, cricket pitches, lawns or pathways; or Signature improving the surface of the ground or similar work and is not let for hire. Date Roadwork General (RDWK). Light vehicle used solely for: / /.

9 Day Month Year the construction, maintenance or repair of Roads or bridges; or Personal Information Collection Notice removal of garbage or night soil; and is Transport for NSW is committed to protecting your privacy a self-propelled plant; and ensuring your personal and health information is a roadwork plant trailer; or managed according to law. a trailer used to carry roadwork plant. Find out why we collect your personal information, including how we use and manage it, by reading our privacy statement at or phone School Student Driver Education Vehicle (SCHL) 13 22 13 to request a copy.

10 Light vehicle used solely or principally by a Government school or a registered non-Government school for the purpose of driver education of students. Surf Life Saving Club Vehicle (SURF). Light or heavy vehicle used on road or road related areas solely to Transport surf rescue boats. Tow Trucks with 'Crane and Hook' Body (TOW). Light vehicle constructed to Partially lift and tow other vehicles, but not carry other vehicles, and the vehicle will be garaged in: (please tick the appropriate Transport District). Sydney Newcastle Wollongong Other Transport District Wheelchair Modified Vehicle (PRIV, with vehicle condition code V88).