SSBA Reporting Forms: Change of Entity and Facility Details

Use this form to change your entity or facility details. If you have physically moved your facility, please contact Health.

Page last updated: 15 August 2019

SSBA Reporting Forms List

Release Date: July 2019

Introduction

Entities must advise the Department of Health (Health) of any changes to the administrative details of the entity or facility as soon as possible and within two business days of the change occurring.

Note: Please do not use this form if:

  • Details for the Responsible Officer or Deputy Responsible Officer have changed. This should be reported using the Change of Responsible Officer Report within two business days of the event occurring.
  • The facility has physically moved or the secure area has changed substantially. This may require a new registration. Please contact the SSBA Regulatory Scheme to discuss.

Providing information to Health

The information you provide to Health is mandated by the National Health Security Act 2007 and will be included on the National Register of SSBAs.

It is important to answer all questions and to provide accurate information. If the information you provide is incorrect or incomplete, Health may require you to provide additional information. This may cause delays.

Privacy

Personal information provided to Health will comply with the requirements of the Privacy Act 1988.

Application Authorisation

Please ensure that you hold the appropriate authority to submit this application on the behalf of the entity or facility. For a registered facility this may be the Responsible or Deputy Responsible Officer or an authorised person appointed by the Responsible or Deputy Responsible Officer.

Instructions on preparing this notification

This document allows electronic entry of information into the required fields. It is recommended that, where possible, this form should be completed on a computer and a copy printed, signed and sent to Health.

All questions marked with an * are mandatory and must be completed. Other fields are to be completed only if the information has changed.

If the space provided in each field is not sufficient to complete your answer, please include any additional information in an attachment with the information clearly marked as to which question it relates to.

Please ensure you retain a copy of this completed form as Health is unable to provide you with copies of submitted documents.

Lodgement

To lodge this form via post you will need to use an opaque envelope and post using Australia Post’s Registered Mail service. You are considered to have submitted the report at the date and time shown on the registered post receipt.

Please do not email or fax forms to Health as these cannot be accepted.

Please submit all postal applications to:

The Director
Health Emergency Planning, Security and Laboratories Section
Department of Health
MDP 140, GPO Box 9848
Canberra ACT  2601

Once Health has received this form, you will be provided with a confirmation of receipt via email to the Responsible Officer for the facility.

Further Information

Please use your facility registration number to refer to any matters relating to your facility.

If you have any queries about this form please contact the SSBA Regulatory Scheme:

Telephone: (02) 6289 7477
Email: SSBA

(This page contains form/s that are intended to be paper based that you can download and complete. If you are using any assistive technology and are unable to use the form please contact us using the Online form and feedback).