Prescribed Accommodation Premises

APPLICATION FOR REGISTRATION OF AN ALPINE PRESCRIBED ACCOMMODATION PREMISES

Section 74 of the Public Health and Wellbeing Act 2008

I/We the undersigned, hereby apply to register/renew/transfer under the provisions of the Public Health and Wellbeing Act 2008 the premises described hereunder and depicted in the floor plan attached lodged with ALPINE RESORTS VICTORIA trading as FALLS CREEK ALPINE RESORT ('FCAR') for the year commencing 1 May 2022.

*Residential Accommodation means any house, building, or other structure used as a place of abode where a person or persons can live on payment of consideration to the proprietor but does not include –

(a) A hotel or motel; or (d) A hostel; or

(b) A student dormitory, or (e) A holiday camp; or

(c) A rooming house.

**Rooming House means a building in which there is one or more rooms available for occupancy on payment of rent in which the total number of people who may occupy that room or those rooms in not less than 4.

PROPRIETOR DETAILS

First Name *

Last Name *

Email Address *

Authority (e.g. Director of Company) *

Company Name *

ABN/ACN *

Postal Address *

State / Province / Region

Postal / Zip Code

Country

Phone Number *

PREMISES DETAILS

Business or Trading Name *

Company Name (if applicable)

Contact person at premises (if applicable):

Address of Premises *

City *

State / Province / Region *

Postal / Zip Code *

Country *

Premises Phone Number *

PRESCRIBED ACCOMODATION DETAILS

Other (Please Specify)

Maximum Number of PERSONS to be accommodated

Number of BEDROOMS available for occupiers on payment of considerations

Number of BEDS in each bedroom (attach separate list if needed)

SUPPORTING DOCUMENTS: One Copy of a floor plan (scale 1:100), including the proposed use of each room, must be submitted with this application. *

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DECLARATION

DECLARATION:

I understand and acknowledge that:

- The information provided in this application is true and complete to the best of my knowledge

- This application forms a legal document and penalties exist for provide false or misleading

information

- I am over 18 years at the time of completing this application

By marking this check box, I confirm that I have read and understood all the statements above.

I Agree *

Signature Of Applicant *

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Date *