Annual Fee Payer Notification of Trade

Print Form

All fields are required except where indicated

This form must be submitted at least two weeks prior to the event.

Name of food premises/vehicle:

Event:

Event Manager:

Event Manager contact number:

Date:

Additional dates:

Address:

Has any of your contact details changed:

YesNo

Details of proposed food handling activity
(EG: List of all food and drink products to be sold):

Do you need to provide an up to date copy of the following? :

Public Liability Insurance document
Food Business Registration Certificate document
Floor Plan document

PLEASE NOTE:

Submitting this application does not automatically result in an approval.
If granted - the approval will be emailed to the applicants.
If you do not receive your approval within two weeks, please contact the City’s Health Services on 08 9411 3589.

By submitting this form you declare that the above information to be true and correct.

Contact

Address

City of Cockburn
Whadjuk Boodja
9 Coleville Crescent,
Spearwood 6163

PO Box 1215, Bibra Lake DC,
Western Australia, 6965

Office opening hours:
8.30am to 4.30pm
Monday to Friday (excluding public holidays)

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