Form F4772 Es PDF Details

Embarking on the journey to obtain or replace an Adult Proof of Age (APA) card under the Adult Proof of Age Card Act 2008 is a process outlined with clarity and precision in the F4772 Es form, specifically designed for residents of Queensland, Australia. This form caters to individuals who are on the brink of adulthood, requiring applicants to be at least 17 years and 11 months old, with the stipulation that the card itself can only be issued upon reaching the age of 18. It illuminates the pathway with detailed instructions for both first-time applicants and those seeking a replacement, underpinning the importance of providing satisfactory evidence of identity (EOI). A notable feature includes the necessity to submit three EOI documents categorized under A and B, alongside additional documents if a change of name has occurred, aimed at ensuring the applicant’s identity with utmost accuracy. Furthermore, it sets expectations about the card delivery process, which varies based on the applicant’s age at the time of application, and introduces a unique aspect of including a Personal Identification Number (PIN) or Shared Secrets for enhanced security. The informational depth of this form encapsulates not only the procedural aspects but also underscores the legal ramification of providing false information, thereby emphasizing the seriousness of the application process while also assuring applicants of their privacy rights and the protective measures in place regarding their personal information.

QuestionAnswer
Form NameForm F4772 Es
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesproof of age form online, proof of age card victoria application form, proof of age card application form pdf, proof of age form

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Adult Proof of Age Card Application/Replacement

Adult Proof of Age Card Act 2008

This form is to be used if you are applying for the issue or replacement of an Adult Proof of Age (APA) card. To apply, you must be at least 17 years and 11 months of age and ordinarily reside in Queensland (Qld). However, you must be at least 18 years of age before an APA card can be issued to you.

The lodgement of this application does not guarantee its approval.

Important information about the delivery of your APA card If you were aged 18 years or over when you made your application, your APA card will be sent to your postal address within 14 days.

If you were under 18 years of age when you made your application, your APA card will be returned to the Department of Transport and Main Roads licence issuing centre where you made your application. You will be notified when your card will be available for collection.

You will not be able to collect your APA card before you turn 18 years of age. When you return to the centre, you must show evidence of identity.

Personal Identification Number (PIN) and Shared Secrets To record your PIN or Shared Secrets on your APA card, please complete the Personal Identification Number and Shared Secrets Application (form F4748).

Evidence of Identity (EOI) Requirements

You must give evidence of your identity. You may do so by presenting your Qld driver licence. If you are unable to present your driver licence, your Qld industry authority, marine licence indicator or APA card may be accepted (conditions apply). If you are unable to present any of these documents you will need to present three (3) EOI documents.

These documents must include at least one Category A document and one Category B document. The third document may be from either category, however, one of these documents must include your signature. If your Qld residential address is not shown on any EOI documents provided, you must also show an Evidence of Qld residential address document.

All documents must be current or expired less than 2 years. Photocopies

and certified copies of original documents are not acceptable.

Please refer to the Evidence of Identity Requirements for Individuals (form F4362) or the Department of Transport and Main Roads (the department) website www.tmr.qld.gov.au for a full lists of EOI, evidence of Qld residential address and change of name documents.

Change of Name Requirements

If you have changed your name or the details of your name are different on the documents provided, you must show a change of name document from the relevant Australian Register of Births, Deaths and Marriages (BDM).

Digital Photo

You may also be required to allow the taking of a digital photo to confirm your connection to the most recent digital photo kept by the department.

1.Personal details

Family name (please PRINT)

Given name/s

Male

 

Female

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Residential address

Postcode

Postal address (if same as residential, write ‘AS ABOVE’)

 

 

 

 

 

 

Postcode

Daytime contact phone number

 

Date of birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

/

 

 

 

 

 

 

 

 

 

 

 

Town and country of birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Eye colour

Height

 

Hair colour

 

Complexion

 

 

 

 

 

 

 

 

 

 

 

 

cms

 

 

 

 

 

 

 

2.Can you show your Qld driver licence, industry authority, marine licence indicator or APA card?

Yes Licence/authority/reference number

No

 

You are required to show three (3) EOI documents

 

 

(refer to Evidence of Identity Requirements for

 

 

Individuals (form F4362)). Please provide details

 

 

of your documents.

Category A (please PRINT)

 

Document type

Document number

(e.g. Australian passport)

(e.g. X0100011)

 

 

 

 

 

 

Category B (please PRINT)

 

Document type

Document number

(e.g. CBA credit card)

(do not give credit/debit card number)

 

 

 

 

 

Category A or B (please PRINT)

Document type

Document number

 

 

 

 

 

 

Evidence of Qld residency address (please PRINT)

Document type

Issue date

(e.g. Telephone account)

(e.g. 10/06/2010)

 

 

 

 

 

 

3.Is your name different to the name/s on your EOI documents?

No

 

Yes

 

 

You are required to show a change of

 

 

 

 

 

name document (refer to Evidence of

 

 

 

 

 

Identity Requirements for Individuals

 

 

 

 

 

(form F4362)). Please provide

 

 

 

 

 

details of your documents. A Change

 

 

 

 

 

Customer Details (form F4214) may

 

 

 

 

 

also be required.

 

Change of name (please PRINT)

 

Document type

 

 

Registration year

(e.g. Qld BDM Issued Document number

Marriage Certificate)

 

(e.g. 001000)

(e.g. 2001)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.Have you been previously issued an APA card in Queensland?

No Go to 6

Yes

Continued over page....

Page 1 of 2 Corporate Forms Area Form F4772 ES V01 Jul 2012

5.What is the reason for the replacement APA card?

(a)because my APA card is damaged, destroyed, lost or

stolen.

 

 

 

 

 

 

No

 

 

Yes

 

Please indicate the reason for

 

 

 

 

 

 

replacement.

 

 

 

 

 

 

 

Damaged

 

 

 

Destroyed

 

 

 

 

 

Lost

 

 

 

 

Stolen

 

 

 

 

 

 

 

 

 

 

 

(b) you have not received your APA card in the mail.

No Yes Please confirm your postal address details.

Postcode

(c) your APA card is defective or faulty.

No Yes Please give details about the defect or fault. Note: You must return your defective/faulty APA card.

(d)

your photo image is no longer a true likeness.

 

No

 

Yes

 

Note: You must return your APA card.

 

 

 

(e)

other reason

 

 

 

 

 

Please provide details.

 

No

 

Yes

 

 

 

 

 

 

 

 

 

 

 

 

 

6.Applicant’s declaration

Sign only in the presence of a departmental person

I declare that I have read all the answers I have given to the questions in this application and that the answers given by me are complete, true and correct in every detail.

I understand that if I have stated anything in this application that is false or misleading, the adult proof of age card granted to me as a result of this application will be cancelled.

I understand that I may be prosecuted for giving or stating any false or misleading information or documents.

I consent to the department taking, keeping and using my information, documents, digital photo and digitised signature for the purposes associated with the grant or replacement of my adult proof of age card as required under the Adult Proof of Age Card Act 2008 or otherwise authorised by law.

I consent to the department verifying my EOI documents or information provided by me with the issuing authority or their agencies.

Applicant’s signature

Date

/ /

It is an offence under the Adult Proof of Age Card Act 2008 to state anything or give a document to an authorised person if you know it contains false or misleading information. The maximum penalty may be more than $6000.

Privacy Statement: The Department of Transport and Main Roads (the department) provides this form under the Adult Proof of Age Card Act 2008 (the Act) so that you may apply for an adult proof of age card. The information or documents collected for the purpose of this application will be accessible by authorised departmental persons and some of this information may be disclosed to the Qld Police Service and interstate agencies that issue adult proof of age cards as allowed under the Act. The department’s card contractor will have controlled access to your information, digitised signature and digital photo to make your card. Your information, documents and digital photo may be accessed by authorised departmental persons or police exercising a power in relation to this Act, or otherwise authorised under the Police Powers and Responsibilities Act 2000. The department will not disclose your personal information, documents, digitised signature or digital photo to any other third parties without your consent unless authorised by law.

Office Use Only (tick where applicable)

Applicant’s EOI confirmed

Applicant’s details confirmed in TICA/TRAILS 1:1 match performed

Application approved

Application not approved

Comment

Authorising person’s declaration

I declare that I have witnessed the applicant’s signature. I am satisfied that the signature accords satisfactorily with the signature appearing on the EOI documents. I also declare that I have sighted the EOI, Evidence of Qld residency and Change of Name documents as required.

Authorising person’s name

Authorising person’s signature

Date

/ /

Office Stamp

Page 2 of 2 Corporate Forms Area Form F4772 ES V01 Jul 2012

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1. The proof of age form online requires specific details to be typed in. Make sure the next blank fields are finalized:

The right way to fill out proof of age card victoria application form part 1

2. After this section is completed, proceed to type in the applicable details in these - Gender, Male M, Female F, Residential address, Do you want your residential, Postcode, Yes, Postal address if same as, Email address, Postcode, Would you like to get enotices and, Yes, You must show three EOI documents, Category A please print Document, and Category B please print Document.

How you can fill out proof of age card victoria application form stage 2

3. This third step should be pretty straightforward, Daytime contact phone number, Date of birth, Town state and country of birth, Is your name different to the, Yes, You must show an EOI change of, Page of TRB Forms Area Form F, and Continued over page - every one of these blanks is required to be completed here.

Date of birth, Is your name different to the, and Daytime contact phone number of proof of age card victoria application form

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4. The fourth section arrives with these blank fields to fill out: Question continued Change of name, Document number for example, Registration year for example, Have you been previously issued, card No, Go to, Yes, Please indicate the reason you, card, your card is, Damaged, Lost, Destroyed, Stolen, and you have not received your card in.

Stage no. 4 for completing proof of age card victoria application form

5. As you come close to the finalization of the document, there are several more points to undertake. Mainly, Note You must return your card, other reason, Please provide details, Applicants declaration, I declare that I have read the, I understand that if I have stated, I understand that I may be, I consent to the department taking, I consent to the department, Date, Authorising persons signature, Date, and Office Stamp must be done.

proof of age card victoria application form conclusion process explained (portion 5)

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