Exporter Name* Exporter Registered Address* Street Address ABN ACN ABN / ACN*Exporter Contact Name* Exporter Email Address* Exporter Contact Phone Number*Ultimate Australian Holding Company Executive Negotiator* Exporter Structure*Select an optionRegistered CompanyIndividualOthers, including for example, PartnershipsHave you previously signed up to the ACT Container Deposit Scheme as a Supplier?* Yes No If you have previously signed up to the ACT Container Deposit Scheme you will not be required to upload photo ID provided your nominated signatories remain the sameSupply Arrangement Number If you have previously signed up to the ACT Container Deposit Scheme as a Supplier, please provide your Supply Arrangement Number Signatory 1Signatory Name* Signatory Title* Signatory Email* File upload (for Photo ID)Accepted file types: pdf, jpg, jpeg, gif, png, bmp, Max. file size: 5 MB.If you have not previously signed up to the ACT Container Deposit Scheme; or you have previously signed up to the NSW Container Deposit Scheme but your nominated signatories have changed please upload photo ID for the first signatory as outlined in the FAQ pdf, jpg, jpeg, gif, png or bmp files of less than 5MB in size Signatory 2Signatory Name* Signatory Title* Signatory Email* If a registered company with more than one director, please enter the name of a second director or company secretary who will sign documents on behalf of the company. If a registered company with a sole director/secretary, please enter the name of the person nominated to witness the signature of the first signatory. If an individual, please enter the name of the person nominated to witness the signature of the first signatoryFile upload (for Photo ID)Accepted file types: pdf, jpg, jpeg, gif, png, bmp, Max. file size: 5 MB.If you have not previously signed up to the ACT Container Deposit Scheme; or you have previously signed up to the ACT Container Deposit Scheme but your nominated signatories have changed please upload photo ID for the first signatory as outlined in the FAQ pdf, jpg, jpeg, gif, png or bmp files of less than 5MB in size.Your message
