Applicants name * First Name Last Name Date of Birth * MM DD YYYY Email * Phone Number * Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Postal address List as above if postal and home address are the same Address 1 Address 2 City State/Province Zip/Postal Code Country Is this a new trailer? * Yes No Will the vehicle be used on a public road? * Yes No What type of vehicle are you seeking an approval for? Single trailer (up to a maximum of 4 low ATM and/or 4 high ATM in a 12-month period) None of the above Is this application for a new or used vehicle New Used When was the trailer built? MM DD YYYY Trailer Length (metres) Width (metres) & Height (meters) Aggregate Trailer Mass (ATM) (kg) Gross Trailer Mass (GTM) (kg) Tare Mass (kg) Has the applicant, or in the case of a body corporate any member of key management personnel, contravened road vehicle legislation? Yes No What type of trailer are you applying for (Boat, Flat deck, box etc)?