Professional Documents
Culture Documents
1. Applicant details (organisation or individual) 3. Section for heavy trailers (over 4.5T GTM only)
Name and address Gross trailer mass (GTM) Axle code
Postcode
4. Customer statement
TfNSW Organisation / Representative driver
Customer number licence no. / customer no. By signing and submitting this form I certify that the
information provided is correct to the best of my knowledge.
I understand that knowingly providing false information may
render me liable under the Road Transport (Vehicle
Contact telephone number Registration) Regulation 2017 and the Crimes Act 1900.
Postcode
Year of manufacture
Catalogue No. 45070887 Form No. 1212 (05/2022) OFFICIAL: Sensitive – Personal Page 1
(when completed)