RTF FormRequest to surrender DNIR licence where dealings have been assessed as an NLRD (update of the previous form 'Combined NLRD Notification & Surrender of DNIR licence) (RTF 243 KB)
Text VersionBelow is the text from the Request to surrender DNIR licence where dealings have been assessed as an NLRD
Part 1: Assessment of an NLRD under Regulation 13 of the Gene Technology Regulations 2001Name of IBC
I declare that:
- The IBC has assessed the dealings described in Table 1 (attached) to be notifiable low risk dealings (NLRD) mentioned in Part 1 or Part 2 of Schedule 3 of the Gene Technology Regulations 2001 (as amended, commencing 1 September 2011);
- Personnel involved in these dealings have appropriate training and experience;
- The dealings are undertaken in facilities that are appropriate for the dealings; and
- Dealings involving transport, storage or disposal of a GMO are undertaken in accordance with the Regulator’s Guidelines for the Transport, Storage and Disposal of GMOs.
IBC rep title
Part 2: Request to surrender a licence for a dealing not involving an intentional release (DNIR)Name of Organisation holding DNIR licence holder
- I declare that I am authorised (as CEO or Delegate of the above organisation) to sign on behalf of the licence holder; and
- I hereby request that the respective DNIR licence(s) be surrendered.
Table 1 – List of dealings relating to Parts 1 & 2 of this form
Current DNIR Number
IBC NLRD Identifier1
* Refer to Schedule 3, Part 1 and Part 2 of the Gene Technology Regulations 2001 (commencing 1 September 2011) for information on appropriate classifications
1 Please include your organisations’ identification number/label issued by your IBC. This reference/number should also be included in your list of new NLRDs notified to the OGTR in your organisation’s annual report (due after 1 July of each year).