MSIC Application Checklist

Your Issuing Body is: Veritas
Step 1: Review the details in Part A of your MSIC Application Form (page 3). If changes are required, please make the changes
on the form in pen and initial.
Step 2: Complete an Operational Need letter.
To be issued with an MSIC you must prove you have an Operational Need for a card. This means your job or business interests
require you to access a maritime security zone unmonitored at least once each year.
If your employer is registered with Veritas, they will be able to assist us to verify your Operational Need for an MSIC. Please contact
us if you are unsure whether your employer is registered with us.
If your employer is not registered with us, you will need to provide us with satisfactory evidence of an Operational Need for an MSIC.
This can be done by providing us a letter, signed by your employer, confirming your Operational Need.
A sample letter is on page 5.
Please ensure that you understand that it is an offence to retain an MSIC if you no longer need it (i.e. MSIC must be returned to the
Issuing Body within 30 days if your Operational Need no longer exists as per the MSIC Conditions of Use [Maritime Transport and
Offshore Facilities Security Regulations 2003, Section 6.08Q ])
Step 3: Gather your original identity (ID) documents. You will need to show:
One Primary ID document, and either
One Secondary ID document, or
Two Tertiary ID documents

Acceptable Forms of Identification:
Primary ID Documents
Birth Certificate (not an extract)
Australian Citizenship Certificate
Document from another country that is evidence that you are a citizen of that country
Passport (not cancelled or expired)
Secondary ID Documents (must be current ID)
Australian driver’s licence
Other licence issued under a law of the Commonwealth of Australia or a state or territory (e.g. fisheries, firearms, etc.)
Commonwealth or a state or territory Govt. Employee ID
Australian tertiary Student ID
Verifiable reference that identifies your name and certifies that the person signing the reference has known you by the name listed
for at least 12 months and that the reference is signed by the applicant and referee. A verifiable reference means a reference
from:
a bank or similar financial institution; or
somebody whose identity has been verified by means of:
2 primary identification documents; or
a primary identification document and a secondary identification document; or
a primary identification document and 2 tertiary identification documents; or
a referee acceptable to the person or body that requires the identification of the identified person.
Tertiary ID Documents (must show your name and residential address and be less than 6 months old)
Signed statement from employer or former employer about that employment; or
Certified copy by Registrar of Titles or similar officer of a record issued under a law about land titles; or
Document issued by a rating authority from its records about land ownership or occupation; or
Document issued by a bank or similar financial institution from its records about a mortgage or other security that applicant gave to
bank or institution; or
Extract from electoral roll compiled by the Australian Electoral Commission; or
Record issued under a law in force in Australia other than a law about land titles.

take your MSIC Application Form (pages 3 . 2. Passport Photo (see information below) and original Identity Documents (see list on page 1. please call to book an appointment. NT Unit 7.000 Australia Post retail outlets nationwide.4). Passport Photo Information Passport photos will be taken free of charge when lodging at our Perth CBD or Darwin office. .Friday.4:00pm (AWST) Darwin Appointments +61 8 8930 3204 Monday . Please see Part D of the application form for a complete listing.Friday. You must provide a document that shows you are an Australian citizen (e. WA . 10:00am . please call us to discuss or continue to lodge your application at any one of over 4.com.2:00pm (ACST) If lodging at the Perth or Darwin office. Please note that some forms of identification may not be accepted by Australia Post for verification of identity. or you must satisfy us (the issuing body) that you hold a current visa entitling you to work in Australia. Western Australia 6000 Darwin. Outside of these hours. Veritas General Enquiries 1300 VERITAS (1300 837 482) or +61 8 9226 0711 Office Hours: Monday .au msic@veritasgroup.Head Office 67 Milligan Street Perth. 10:00am . your Australian birth certificate. Darwin Office Please call +61 8 8930 3204 to book an appointment. Veritas may require an applicant to have the authenticity of a proof of identification document authenticated by the government that issued the document.g. Entitlement to work.msic. taken within 6 months) Photograph shows holder’s full face and his or her head and shoulders Additional Notes: 1.Step 4: Lodge your Application To complete your application. Australian Passport. or Australian naturalisation certificate).Friday. Photograph must be recent (that is. 42 Toupein Road Yarrawonga. Australia Post will accept your application and forward it to us for processing. NT 0830 Perth Appointments 1300 VERITAS (1300 837 482) or +61 8 9226 0711 Monday . Authentication of certain foreign documents.au Fax: +61 8 6323 0425 Perth CBD. Step 3) to: Option 1: In Person at Veritas Perth CBD Office Please call 1300 VERITAS (1300 837 482) or +61 8 9226 0711 to book an appointment. Option 2: Australia Post Once completed.au/pol/app/locate/post-office/maritime-security-identity-card to find the Post Office nearest you.com.5:00pm (AWST) www. 9:00am . Operational Need letter (page 5).net. Go to http://auspost. Passport photos can be taken at Australia Post but you will bear the cost of this photo.

$0.00 . When you turn 18 you must apply for a Standard MSIC. Photos can be taken if lodging at Veritas.caldescasas@infrastructure. Sign: Date: Part C: Payment Details TAX INVOICE Veritas Engineering Pty Ltd 57 107 945 988 Lodge completed application at Veritas' Perth CBD or Darwin office OR at any Australia Post nationwide. Provisional MSIC Tick this box if you are under 18 years of age. Section 6. AusCheck Privacy Notice. your identity documents and Operational Need letter to Veritas or your Australia Post outlet to have your verification of identity check completed and to submit your forms. EFTPOS.net. contact Veritas on 1300 VERITAS (1300 837 482) or +61 8 9226 0711. Part A: Applicant Information Application Type: Standard MSIC 2 Year expiry 4 Year expiry The 4 year option includes a second background check at the end of 2 years.07F. a copy of the brochure. NT. CrimTrac and the Department of Immigration and Border Protection. No Payment Collected . Cash. MSIC based on your ASIC Your MSIC will expire on the same date as your ASIC.au Department of Infrastructure and Regional Developm Instructions: 1. or will require. 0800 Australia 24 Mitchell str Darwin. Credit Card (VISA.$0. Cheque. Employer Sponsored: Validity based upon Employer Sponsored Payment. I understand that my personal information will be used by AusCheck to coordinate a background check through the Australian Security Intelligence Organisation. Statement of Operational Need: I acknowledge that I have an Operational Need to hold an MSIC as my occupation or business interests require. Please review the details in Part A of this application. Approved applicants will typically receive their MSICs in 1 .au Home Address Postal Address 24 Mitchell str Darwin. For queries. MasterCard) accepted. me to have unmonitored access to a maritime security zone at least once each year (in accordance with the Maritime Transport and Offshore Facilities Security Regulations 2003. The information I have provided in this application is correct to the best of my knowledge.gov.2 weeks however times do vary. Western Australia 6000 Darwin Office Unit 7. I may request from my Issuing Body or access via the AusCheck website. Current ASIC Number: Previous MSIC Number (if applicable): Personal Details Contact Details Surname (Present): Given Names: Date of Birth: Caldes Casas Javier 16 Sep 1968 Home Phone: Work Phone: Mobile: Email: 0435449979 javier. 42 Toupein Road. If changes are required. 3.00 Cheques made payable to "Veritas Engineering" EFT Payments to: BSB 016-359 Acct: 4948-92079 Ref: VEP0092312 Option 2: Lodge at Australia Post Present completed application in person at any Australia Post nationwide displaying Bank@Post signage.Application Identification Number MSIC Application VEP0092312 www. Yarrawonga. NT 0830 Employer Sponsored: No Payment Collected . make the changes on the form in pen and initial. Passport type photos required if lodging at Australia Post. NT. 2. Take this form. where necessary. which explains how AusCheck will use my personal information.msic. Perth. Option 1: In person at Veritas Present completed application at our Perth CBD or Darwin office: Perth CBD Office 67 Milligan Street. 0800 Australia Part B: Declaration of Operational Need (sign in presence of agent conducting verification of identity) I understand that I am applying for a Maritime Security Identification Card.

Part G: Card Issue (Issuing Body Use Only) MSIC Card Number: V E P / ___ ___ ___ ___ ___ ___ ___ Collected by (Applicant) Signed: Print: Date: Employer: Emp. Applicants may verify their identity at either an Australia Post outlet or by a Veritas representative. applicant holds a visa entitling him or her to work in Australia. or The issuing body is satisfied that he or she holds a visa entitling him or her to work in Australia Part F: Operational Need (Issuing Body Use Only) Applicant provides evidence that he or she has an Operational Need (e. or Yes Yes Document issued by a rating authority from its records about land Ref No. or A copy (certified under section 44 of the Australian Citizenship Act 1948) of an Australian citizenship certificate granted to him or her. Ref No.: Date of Expiry: State: of the Commonwealth of Australia or a State or Territory. ____________________________________________________________ documents. about somebody (the identified person) means a or reference from: Types of verification of referee (list types and details as above): a.: Date of about a mortgage or other security that applicant gave to bank or institution. or A document issued to him or her under the law of another country that is evidence. ____________________________________________________________ ii. a bank or similar financial institution.: Date of ownership or occupation. or 2. or Reference (Complete if ticked) Ref No. or Yes Yes Extract from electoral roll compiled by the Australian Electoral Commission. or Applicant’s employer confirms applicant’s Operational Need. a referee acceptable to the person or body that requires the identification of the identified person. Please check the list below to confirm which types of documents are accepted as proof of identity by each agency.: Date of titles.: Date of Issue: If a foreign passport is presented.: Date of Issue: Ref No. State or Territory Government Employee ID issued to him Ref No. One secondary identification document. or iii. his or her Australian birth certificate. a driver’s licence) issued to him or her under a law Ref No. under that law. Australian Passport. Ref No. A verifiable ref. or b. or c. letter from employer).: Type: . or b. 2 primary identification documents. and the reference is signed by the applicant and the Branch: _____________________ referee. Interviewer's Declaration I declare that the attached photograph is a true likeness of the applicant.g.: Date of Issue: Place of Issue: Type: Country: Country: A passport issued to him or her (must not be cancelled or expired). or Australian naturalisation certificate.Part D: Verification of Identity (Issuing Body Representative or Australia Post Use Only) Verification of Identity: Applicant must prove their identity by showing one primary identification document and either: a. Accepted at Primary Identification Documents AusPost Veritas Documents (Tick when presented) Yes Yes Yes Yes No Yes Yes Yes A certified copy (that is. in a register of births. or Yes Yes Certified copy by Registrar of Titles or similar officer of a record issued Ref No. or Yes Yes An Australian tertiary student identification document issued to him or her. somebody whose identity has been verified by means of: 1. Contact No. a copy certified by a Registrar of Births or similar officer to be a correct copy) of the entry.: Date of Issue: Organisation: or her. 4. Visa number: _______________ Expiry Date: _________ Secondary Identification Documents (Must include photograph OR signature of applicant AND must be current ID) Yes Yes A licence (for example. a primary identification document and a secondary identification document. that he or she is a citizen of that country.g. Ref No. or Yes Yes Document issued by a bank or similar financial institution from its records Ref No. Two tertiary identification documents.: Date of Issue: Organisation: or No Yes A verifiable reference that identifies the applicant by name and certifies that Details of referee: the person who signs the reference has known the applicant by that name Name of Bank: __________________________________ for at least 12 months. of his or her birth (not an extract).: Date of under a law about land titles. Issue: Type: Issue: Type: Issue: Type: Issue: Issue: Type: Signature of Interviewer: Printed Name: Date Signed: Part E: Entitlement to Work (Issuing Body Use Only) Evidence presenting indicating that the applicant is an Australian citizen e.: Date of or No Yes Record issued under a law in force in Australia other than a law about land Ref No.: Date of Issue: Ref No. a primary identification document and 2 tertiary identification 3. ____________________________________________________________ i. or Yes Yes Commonwealth. I have conducted an interview and confirmed the information provided in this application for an MSIC against original documentation submitted. ____________________________________________________________ Attach photocopy of reference Tertiary Identification Documents (Must include name AND residential address of applicant AND be less than 6 months old) No Yes Signed statement from employer or former employer about that Attach a photocopy of reference employment.

Business unit / project (if applicable) ________________________________ Purchase order number or cost code ________________________________ Select if MUST be: 2 years or 4 years or Applicant to select . Name: Position: Signed: Organisation: ABN: Address: Contact Number: Email: Payment Details Applicant to pay Company to pay.Statement of Operational Need for a Maritime Security Identification Card (MSIC) Section 6. him or her to have unmonitored access to a maritime security zone at least once each year (in accordance with the Maritime Transport and Offshore Facilities Security Regulations 2003. in writing. contractors.au Date: _____________________________________ Dear Veritas Engineering (MSIC Issuing Body). apply to an issuing body for an MSIC". Cloisters Square. Signed statements should be posted or scanned and emailed to: Veritas Engineering Pty Ltd.08B of the Maritime Transport and Offshore Facilities Security Regulations 2003 states that "a person may. Section 6.08Q]).07F). I confirm that the following individual(s) has/have an Operational Need for an MSIC: First. PO Box 7696. Middle. or will require. I acknowledge that a person has an Operational Need to hold an MSIC if his or her occupation or business interests require. or other authorized persons to serve as documentary evidence of the listed applicants' Operational Need to possess an MSIC. An application for an MSIC will not proceed until a signed Statement of Operational Need is received for each applicant.com. MSIC must be returned to the Issuing Body within 30 days if their operational need no longer exists as per Conditions of Use [Section 6.e. Last Date of Birth The above named individual(s) also understand that it is an offence to retain their MSIC if they no longer possess an Operational Need for it (i. Western Australia 6850 or msic@veritasgroup. Employers or designated facility operators may complete this letter on behalf of their employees.