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Schedule 1

Forms

In force

Schedule 1 Forms

[r. 3]

Form 1

Fishing and Related Industries Compensation (Marine Reserves) Act 1997

APPLICATION FOR COMPENSATION

Application1 is made to the Minister for Fisheries by ........................................... .................................................................................................................................................................................. of .......................................................................... .......................................................................... for compensation under section 5 of the Act. 2

Details of authorisation3 held by the applicant

Event4 on which the claim for compensation is based

Amount of compensation claimed5

$

Manner in which amount of compensation claimed was calculated

Dated: ..................................................

...............................................................

Applicant

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