Form 498 Asic – Fill Out and Use This PDF

ASIC ApplicationARN:

Section F: Application for Aviation Security Status Check*

Note: Not applicable for applicants under 18 years of age.

1. Permanent Residential Address for Past Ten Years – if not enough space please attach additional sheet

	List Current address first then previous addresses below, covering past TEN years.		Period of residence *
	There must be no gaps greater than 3 months between addresses.		If actual dates are unavailable,
	Must be full address details including Street, Town, State and Postcode *		details of year of residence will
			suffice
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	2. Criminal/Traffic Charge, Conviction Or Pecuniary Penalties
	(i) Are you the subject of any criminal or traffic charge(s) still pending					 Yes 		No
	(ii) Do you have any conviction(s) or finding(s) of guilt which are less than ten (10) years old, or any juvenile					 Yes 		No
	conviction(s) or finding(s) of guilt which are less than five (5) years old?
	(iii) Do you have any conviction(s) or finding(s) of guilt which are over ten (10) years old, or five (5) years for					 Yes 		No
	juvenile conviction(s) or finding(s) of guilt where the sentence imposed was LESS than thirty (30) months
	imprisonment for offences of the type(s) mentioned at (i) on page 15 (i.e. offences for which an exclusion
	has been granted)
	(iv) Do you have any conviction(s) or finding(s) of guilt which are over ten (10) years old, (or five (5) years for					 Yes 		No
	juvenile conviction(s) or finding(s) of guilt where the sentence imposed was GREATER than thirty (30)
	months imprisonment?
	If you answered YES to any of the above questions, please attach details:
	Form 498 07/2013	Application for Aviation Security Identity Card (ASIC)					page 5 of 7

ASIC Application	ARN:

SECURITY-IN- CONFIDENCE

(When completed)

Commonwealth of Australia

PART EXCLUSION

COMPLETE IF APPLYING FOR AN ASIC

CONSENT TO OBTAIN PERSONAL INFORMATION

(For categories where PART EXCLUSION has been granted from

spent convictions legislation)

I, _________________________________________________________________ hereby:

(Full name - BLOCK LETTERS and in INK)

(i)acknowledge that I have read the guidance material provided with this Form and understand that I do not have to disclose old protected convictions information, which is described under the heading Spent Convictions Scheme, except any type listed below for which an exclusion has been granted;

Offences against Part 2 of the CRIMES (AVIATION) ACT 1991 AND OR PART 5.3 OF THE CRIMINAL CODE ACT 1995.

(ii)certify that the personal information I have provided on this form relates to me and is correct;

(iii)consent to Civil Aviation Safety Authority

•forwarding this form and my personal information to the Department of Transport and Regional Services and/or the Australian Federal Police and/or the Police Services of the States or Territories of the Commonwealth of Australia and providing relevant information to the above organisations;

•forwarding my personal information to AusCheck to co-ordinate a background check where necessary.

(iv)specify entitlement applied for as being: Aviation Security Identification Card (ASIC);

(v)consent to the AFP or other relevant Australian police force(s) extracting from their records copies of traffic violations, and criminal and/or traffic records relating to me pending before a Court and/or details of convictions or findings of guilt which have been recorded against me and which are not covered by Part VIIC of the CRIMES ACT 1914 dealing with spent convictions;

(vi)acknowledge that any information provided by me on this Form or by the police as a result of the records check may be taken into account by the organisation mentioned in (iii) above in assessing my suitability to receive the entitlement.

Signature ___________________________________________________ Date

/

/

Note: The information you provide on this form and which the police provide to CASA, AusCheck and the Department of Transport and Regional Services on receipt of the form, will be used only for the purpose stated in the guidance material in form 498 unless statutory obligations require otherwise.

ALSO COMPLETE THE APPLICATION FOR AVIATION SECURITY IDENTITY CARD

INCLUDED IN THIS FORM

Form 498 07/2013

Application for Aviation Security Identity Card (ASIC)

page 6 of 7

ASIC Application - Guidance

Operational need	An ASIC Issuing Body may only issue an ASIC to a person if they have an operational need. CASA
for an ASIC	may only issue ASICs to pilots and CASA employees.
	CASA will only issue an ASIC to a pilot if they need to fly to or from a security designated airport that
	has regular public transport operations. A list of these airports is available at the following website link
	www.infrastructure.gov.au/transport/security/aviation/legislation/overview/airport.aspx
	Also, CASA will only issue an ASIC to a pilot if they have a current medical certificate, or CASA has an
	application for the initial issue or renewal of a medical certificate. A person applying for a pilot licence
	for the first time can apply for an ASIC through CASA but the ASIC will not be issued until the licence
	has been issued.
	Please provide an Australian postal address on your application. An ASIC cannot be posted to an
	overseas address.
Incomplete	All incomplete applications will be returned to the applicant for completion and re-submission. You
applications	must provide an Australian postal address on your application. There may be lengthy delays in
	receiving a returned, incomplete application, if you only provide an overseas address.
Where to send	Applications can be posted to:	CLARC - CASA
your application		GPO Box 2005
to
		Canberra ACT 2601
Applicants must	Applicants must be at least 16 years of age before they can be issued with an ASIC.
be 16 years of
age
Non-Australian	Applicants who are not Australian citizens must undergo an immigration check regardless of their age.
citizens
	Note: Your immigration check can only be completed once you have arrived in Australia.
	Immigration checks can only be processed during week days. A stop-over of several hours may not be
	sufficient.
Passport photos	Applicants are required to provide 2 identical passport-sized photographs (one of which must be
and specimen	certified as a true likeness of the applicant). The photographs must meet the requirements below:
signature	Photograph must:

•Have been taken within the last six months;

•Be in portrait format: between 35mm and 40mm wide and between 45mm and 50mm high;

•Be in good quality colour on high quality paper, with no ink marks on the image;

•Have appropriate brightness and contrast to show skin tones correctly. Its resolution should not be grainy; but sharp in focus and clear;

•Have a plain, light-coloured background and be taken with uniform lighting (no shadows across the face);

•Be a close-up shot of you looking straight at the camera, so your head takes up most of the photograph (70-80% - see diagram on page 10 of the application form);

•Show you with a neutral expression and with your mouth closed;

•Show your face square on with both ears visible (if the hair covers the ears, both edges of the face must be visible);

•Show the top of your top of shoulders (square on, not in a style that portrays you looking over one shoulder);

•Show your eyes clearly open and visible, not obscured by your hair. If glasses are worn avoid tinted lenses and heavy frames, if possible. Your eyes must be seen clearly through glasses, with no flash reflection from the glasses;

•Show you without any hat or other head covering – if you wear a head-covering for religious reasons, we will accept a photograph of you wearing this, but your features must be visible

from top of forehead to tip of chin, and from both sides of the face.

Securing Photograph:

•Attach one photo FACE UP – the photo image should be visible – use an adhesive on the back of the photo and DO NOT staple or tape over the top of the photo – this photo is scanned, so ensure it is not marked in anyway;

•Attach one photo FACE DOWN – the certification details on the back of the photo should be visible – attach the photo so that it can be lifted and its photo image checked against the FACE UP photo.

Signature must:

•Be witnessed by the same person certifying the proof of identity documents and the applicant's photograph;

•Be contained within the signature box and be written using a black pen.

Form 498 07/2013

Application for Aviation Security Identity Card (ASIC)

page 1 of 6

ASIC Application - Guidance

Proof of	Regardless of your age, you are required to prove your identity to CASA. In order to do this you are
Identification	required to submit certified identification documents:
documents	1 primary identification document and 1 secondary identification document OR
	1 primary identification document and 2 tertiary identification documents.

Primary Identification Documents (PID):

•Current Australian or foreign passport;

•A certified copy of a full Birth Certificate (certified by Registrar of Births or similar officer) – note you must show the original document from the Registrar to the person certifying the documents (note a full birth certificate includes your parent’s details – a birth extract is not satisfactory);

•Document of another country proving citizenship of that country;

•Copy (certified under section 44 of the Australian Citizenship Act 1948) of Australian citizenship certificate.

Secondary Identification Documents (SID):

Note: – A SID must have a recent photograph or signature of the applicant:

•A valid photo flight crew licence issued by an ICAO Contracting State (PID must be a current passport);

•A current licence (e.g. an Australian driver's licence) issued under a law of the Commonwealth of Australia or an Australian State or a Territory;

•Australian Government employee identification (must have been issued by or for the Commonwealth of Australian or State or Territory to the applicant who is employed by or for the Australian Commonwealth, State or Territory);

•Australian student identification document (issued to the applicant who must be a student at a tertiary education institution in Australia);

•A verifiable reference from:

a)A bank or financial institution; or

b)A referee acceptable to CASA (any person who can certify POI documents – see below); or

c)Somebody whose identity has been verified by means of certified copies of: two PIDs; or one PID and one SID; or one PID and two TIDs.

The reference must:

•Identify the applicant by name

•State that the referee has known the applicant by that name for more than 12 months; and

•Be signed by both the applicant and the referee.

Tertiary Identification Documents (TID):

Note – A TID must set out the applicant's name and current address:

•A foreign photographic driver’s licence (PID must be a current passport);

•A signed statement by the applicant's employer or former employer about that employment;

•Copy (certified by an Australian Registrar of Titles or similar officer) of a record issued under a law about land titles;

•A document issued by an Australian rating authority (local government) from its records of land ownership or occupation;

•A document issued by an Australian bank or financial institution from its records of a mortgage or other security given by applicant;

•An extract from the electoral roll compiled by the Australian Electoral Commission;

•A record issued under a law in force in Australia other than a law about land titles (e.g. State issued proof of identity cards that set out the applicant’s name and current address).

Certifying	Who can certify a copy of identification documents?
identification
documents	• Any person who is entitled to witness an Australian Commonwealth Statutory Declaration (see
	list on CASA’s website);
	• A CASA delegate or employee;
	• A CASA appointed Designated Aviation Medical Examiner or Designated Aviation
	Ophthalmologist.
	When certifying a proof of identification document use the following words:
	“This is a true copy of the original document, sighted by me [name], [signature], [date], [qualification
	you have to certify documents – e.g. JP], [Qualification Number – e.g. JP ID].
Form 498 07/2013	Application for Aviation Security Identity Card (ASIC)	page 2 of 6

ASIC Application - Guidance

	Certifying foreign CASA may require an applicant to have the authenticity of a proof of identification document verified by
	documents	the government that issued the document.
		Translation of foreign documents
		All documents must be in English or accompanied by an official English translation.
		A registered translator must compile the translation. You should ask the Australian Embassy, High
		Commission or Consulate in the country where the translation is to be made if you need details of
		translators. If the translation is to be made in Australia, contact the Australian National Accreditation
		Authority for Translators and Interpreters (NAATI). Information on the services that NAATI provides is
		available on their website.
	Conditions of	1.	These Conditions
	Issue and Use of
			These are the conditions on which an ASIC is issued to you by CASA pursuant to the Aviation
	an Aviation
	Security		Transport Security Regulations 2005 (‘Regulations’).
	Identification	2.	Application for ASIC
	Card
			When you apply for an ASIC, you must give CASA a completed application containing:
			(a) All of the information required to be completed in the application form;
			(b) Your consent to CASA requesting various record checks including security, law
				enforcement and citizenship records;
			(c) Your signature, certifying that all the information you have provided is correct, in order to
				determine your suitability to be issued with, and continue to hold, an ASIC; and
			(d)	The correct fee.
			If you do not complete all sections required in the application form, or you include information
			which CASA determines to be false or misleading, CASA may refuse your application for an
			ASIC.
			CASA will decide whether to issue you with an ASIC in accordance with the requirements of the
			Regulations and any other relevant matters. The Department of Transport and Regional
			Services must assess your criminal history and approve CASA to issue the ASIC. An ASIC is
			normally valid for 23 months but may expire in a shorter period.
			To comply with the Regulations, CASA will request security, law enforcement and citizenship
			records checks on applicants. CASA requires your consent and you must produce the
			identification detailed in the application form.
		3.	Purpose of an ASIC
			An Aviation Security Identification Card (ASIC) is an identification card which is used to identify a
			person who has been subject to a background check. An ASIC is required to obtain unescorted
			access to the secure areas of security controlled airports that have regular public transport (RPT)
			services.
		4.	Use of an ASIC
			You must represent to CASA that you have an operational need for frequent access to a secure
			area of one or more security controlled airports and must acknowledge that you:
			(a) Will not enter or stay in a secure area of a security controlled airport unless you have a
				lawful purpose (Regulation 3.11) for being in that secure area;
			(b) Will not give your ASIC to anyone else to use. It is for your use only while on duty; and
			(c) Will keep your ASIC secure at all times (even when you are not using it).
			It is an offence under the Regulations if you contravene paragraph 4(a) above. It is also
			an offence under the Regulations if you are in a secure area using an invalid ASIC or an
			ASIC that was not issued to you.
		5.	You must display your ASIC
			You must properly display an ASIC at all times in a secure area. This means the ASIC must be
			displayed:
			(a)	Above waist height;
			(b) At the front or side of your body; and
			(c) With the whole front of the ASIC clearly visible (Reg 1.04).

You are not properly displaying an ASIC if anything adhering to it obscures a photograph or anything else on it.

It is an offence of strict liability under the Regulations if you fail to properly display your

Form 498 07/2013

Application for Aviation Security Identity Card (ASIC)

page 3 of 6

ASIC Application - Guidance

ASIC in a secure area unless you are an exempted person as defined by the Regulations

3.03 & 3.13.

6.Supervising Visitors

In supervising a person who has been issued with a Visitor Identification Card (VIC), an ASIC holder must adhere to any requirements specified by the airport operator.

It is an offence of strict liability under Regulation 3.03 for the ASIC holder to leave a VIC holder unsupervised.

7.Notifying CASA in certain circumstances

You must notify CASA within 30 days if you change your name.

Failure to do so is an offence under Regulation 6.42.

You must notify CASA within 7 days if you:

(a)Become an ‘unlawful citizen’;

(b)No longer need frequent access to a secure area or need to enter a secure area for operational purposes;

(c)Change your residential address, change your name or contact details;

(d)Subsequently discover that the information you have given in your ASIC application was false or misleading.

If the holder on an ASIC is convicted of an aviation security relevant offence, he or she must notify CASA in writing of the conviction and any sentence within 7 days.

8.Return of ASIC

You must return your ASIC to CASA within one month if:

(a)Your ASIC has expired;

(b)CASA notifies you that your ASIC has been cancelled;

(c)Your ASIC has been damaged, altered or defaced (permanently or temporarily); or

(d)You no longer need to enter the relevant secure area for an operational purpose.

It is an offence of strict liability under the Regulations if you fail to return your ASIC to

CASA as required by this clause. (Reg 6.45).

9.Cancellation or Suspension of ASIC

CASA may cancel your ASIC if you fail to comply with any of these conditions or the Regulations. For example, if you:

(a)Fail to supervise the holder of a Visitor Identification Card (VIC) while that person is in a secure area;

(b)Have given your ASIC to someone else to use to gain entry to a secure area;

(c)Are found in a secure area otherwise than for an operational purpose (for example, you are not on duty);

(d)Have failed to notify CASA of any changes as set out in clause 7 (above);

(e)Provided information in your ASIC application which CASA discovers was false or misleading;

(f)Have failed to display a valid ASIC as set out in clause 5; or

(g)Misuse your ASIC.

There are other circumstances in which CASA may cancel your ASIC. Other such circumstances are set out in the Regulations. The ASIC must be returned to CASA immediately upon notification of the cancellation.

CASA may disqualify an ASIC holder from holding an ASIC for contravening the requirements to display an ASIC in a secure area under the Regulations.

10.Loss of ASIC

You must notify CASA within 7 days in the form of a statutory declaration if your ASIC has been lost, stolen or destroyed.

It is offence of strict liability if the holder does not make a report, in the form of a statutory declaration, of the loss to CASA within 7 Days of becoming aware of the loss, theft of destruction (Regulation 6.46).

In addition to this CASA requires the holder of an ASIC to make a report of the theft, loss or destruction to the local State or Territory Police and an event number must be supplied to CASA at the time of notification.

Form 498 07/2013

Application for Aviation Security Identity Card (ASIC)

page 4 of 6

ASIC Application - Guidance

	11.	Access Control Conditions of Issue and Use
		Access to an airport is the responsibility of the airport operator.
	12.	Renewal of ASIC
		It is your responsibility to ensure your application is lodged in sufficient time to be re-issued with
		another ASIC prior to the current one expiring. No extensions will be granted. If your ASIC
		expires you will be required to operate with a visitor pass which will require you to be under
		constant supervision by a valid ASIC holder.
	13.	Acknowledgement
		You acknowledge that the issue to, and use by you of an ASIC is subject to the following
		conditions of issue and use for an ASIC (‘Conditions’):
		(a) The Aviation Transport Security Act 2004 as amended (‘Act’);
		(b) The Aviation Transport Security Regulations of 2005 as amended (‘Regulations’);
		(c) Conditions of issue and use for an Aviation Security Identification Card (ASIC) as detailed
		on this form;
		(d) You must acknowledge and agree that:
		(i) Camera/Video surveillance may be carried out at security controlled airport from
		time to time for the purpose of safeguarding against unlawful interference with
		aviation; and
		(ii) You and/or goods in your possession may be subject to inspection on entry, exit or
		while in the secure area of a security controlled airport.
Spent	On 30 June 1990, new Commonwealth legislation relating to the collection, use and disclosure of old
Convictions	conviction information came into effect. This new law is commonly known as the Spent Convictions
Scheme	Scheme.
	The aim of the Scheme is to prevent discrimination on the basis of certain old convictions once a
	waiting period has passed and provided the individual has not re-offended. The Scheme also covers
	convictions where an individual's conviction has been set aside or pardoned.
	An individual whose conviction is protected by Part VIIC of the Crimes Act 1914 does not have to
	disclose that conviction to any person, including a Commonwealth authority, unless an exclusion
	applies. Commonwealth authorities are prohibited from taking into account, or from disclosing without
	consent of the individual, such conviction.
	A spent conviction is a conviction for a Commonwealth Territory, State or foreign offence, which
	satisfies all the following conditions:

•It is 10 years since the date of the conviction (or 5 years for juvenile offenders);

•The individual was not sentenced to imprisonment, or was not sentenced to imprisonment for more than 30 months;

•The individual has not re-offended during the 10 years (5 years for juvenile offenders) waiting period; and

•A statutory or regulatory exclusion does not apply. (A full list of exclusions is available from the Privacy Commission.)

The Attorney General, on the recommendation of the Privacy Commissioner, has granted exclusions, both partial and full, from the operation of the Scheme for several categories of employment. There are also statutory exclusions contained within the Act. This means that applicants for those positions must declare all convictions where a full exclusion exists or conviction for specific offences where partial exclusion exists.

An exclusion to the scheme applies to the following offences where an issuing body (within the meaning of regulation 6.01 of the Aviation Transport Security Regulations 2005) is assessing whether to issue an aviation security identification card (within the meaning of regulation 1.03 of the Aviation Transport Security Regulations 2005) to a person in accordance with Part 6 of those Regulations.

•Offences against Part 2 of the Crimes (Aviation) Act 1991 (except section 15);

•Offences against Part 5.3 of the Criminal Code.

Form 498 07/2013

Application for Aviation Security Identity Card (ASIC)

page 5 of 6