AMCAS Subscriber Application Nominated Carrier / Supply chain partner information Parent Company Name * Company Organisation * Company Organisation ABN * Primary Contact * Number of Employees Name * First Name Last Name Position * Email * Phone (Mobile) * (###) ### #### Phone (Work) (###) ### #### Company Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Audit Site Name and Location(s) * Proposed Audit Date * MM DD YYYY Select your Preferred Auditor * Please note: auditors can and do travel interstate, at an added cost. Aaron Armstrong - NSW Belinda Curr - NSW Bernie O’Hara - SA Brenton Anderson - QLD Chris Catchpole - QLD Chris Westlake - QLD David Berner - VIC Glyn Castanelli - VIC Greg Harmes - NSW Jim Murray - NSW Jodie Broadbent - VIC Jodie Jones - SA Paul Molenaar - VIC Peter Little - NSW Sandeep Singh Dhillon – QLD Scott Foreman - SA Sean Minto - NSW Sue Archer - VIC Your Role (Select one or more) * Operator Prime contractor Consignor Consignee Loading Manager Loader/Unloader Scheduler Packer For Roles information, refer to Audit Framework document Appendix B - CoR Roles Last audit date * MM DD YYYY Reason for AMCAS Audit * Who has requested you to be audited? * Structure (select applicable) * Small Business (Carrier: less than 50 heavy vehicles, non-carrier: less than 50 contractors/employees) Medium Business (carrier: 50>99 heavy vehicles, non-carrier: 50>99 contractors/employees) Large Business (Carrier: 100 or more heavy vehicles, non-carrier: 100 or more contactors/employees) Agreement * I confirm that I have read, understood and accept the AMCAS Licence Terms and Conditions. Click here for Terms and Conditions Audit Framework * I acknowledge that I have read, understood and accept the AMCAS Framework Click here to view the AMCAS Audit Framework Privacy note: The above information is being collected, and will be held, by LSS for the purposes of administering the AMCAS auditing program. Click here for Privacy Statement Thank you for your application. We will be in contact with you shortly. Should you have any queries, please do not hesitate to contact us via amcas@logss.com.au or +61 3 5911 8026.