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INFORMATION REQUIRED WITH REGARD TO ALL CERTIFICATE APPLICATIONS

SECTION A:

DETAILS RELATING TO FACILITY AND CONTAINED USE ACTIVITIES 1.

Full details of facility where the activity is to be conducted including postal and physical address and description of location facility

2. Personal details of person(s) responsible for the work relating to the activity including name of person(s) and qualifications

3. Description of the facility including the layout thereof and construction materials

l 4. Details on waste management including the waste to be generated, their treatment, final form and destination

5. Accident prevention procedures and plans and emergency response plans

6. Safety of personnel procedures and plans

7. Risk assessment report and risk management plan

8. List of responsible personnel/persons including names, qualifications and responsibilities

9. The type of contained use activity or activities involved The above information must be provided with regard to each facility to which the application relates.

SECTION B:

DECLARATION

Declaration by responsible person submitting application that information provided is factually correct and truthful.

SECTION C:

APPLICANT AND GMO INFORMATION

1. Name of applicant and postal, physical and email address

2. Relevant facility (if applicable)

3. The purpose of the genetic modification (brief description of proposed activities) and the containment levels involved

4. List of the GMO(s) involved or intended to be involved The above information must be provided with regard to each facility to which the application relates.