Office 150 Albert Road, South Melbourne, VIC 3205

Postal address PO Box 2057, South Melbourne, VIC 3205

Telephone (03) 9685 7333 Facsimile (03) 9696 5284

Application for a Meat Processing Facility Licence

Email info@primesafe.vic.gov.au
www.primesafe.vic.gov.au

ABN 39 877 327 401

Licence type

Licence number Fee payable (See reverse for payment details) $ (GST exempt)

Section 1: Applicant Details

Name of applicant ABN / ACN:
(Person or Incorporated Company)

Postal address

Postcode

Nominated operator of the facility Operator mobile

If the applicant is a corporation, an officer of the corporation must be nominated as the operator of the facility.
NOTE: If the applicant is a partnership, a partner must be nominated as the operator of the facility. Email
If the applicant is a person, the applicant must be the operator of the facility.

Section 2: Facility Details

Trading name of facility

Location address

Postcode

Facility phone Facility fax

Estimated annual throughput of facility unit/tonnes

(Not applicable for Retail Butcher Shops)

Section 3: PrimeSafe Approved Auditor

BSI DQS SGS PrimeSafe DAWE
NOTE: An application cannot proceed until an applicant has entered into an agreement with a PrimeSafe approved auditor.

Section 4: Smallgoods (Only applicable to Retail Butcher Shops and Further Meat Processing facilities)

Will smallgoods be manufactured at the facility during the period of this licence? Yes No
NOTE: Smallgoods are defined as ready to eat meat products or meat products that are cooked and then sold chilled. (Fresh sausages are not considered smallgoods)

Section 5: Applicant History

Has the applicant/operator, associate* or any director, partner, trustee, executive officer, secretary or any other officer or person associated
or connected with the owners, administration or management of the applicant’s business been:
(i) found guilty or convicted of an offence against any of the following Victorian Acts? (ii) found guilty or convicted of any (iii) c
 onvicted anywhere
• Meat Industry Act 1993 • Public Health and Wellbeing Act 2008 offence against any Act of the of any offence?
• Abattoir and Meat Inspection Act 1973 • Food Act 1984 Commonwealth or of any State (This does not include
• Livestock Disease Control Act 1994 • Dairy Act 2000 or Territory which corresponds traffic offences)
• Poultry Processing Act 1968 • Seafood Safety Act 2003 to those Victorian Acts referred
to above?
Yes No Yes No Yes No

If you have answered “YES” to any of the above, please attach details (including names of the offender, nature of the offence and date of conviction and penalty).
NOTE: * “associate” as defined in Section 16(3) of the Meat Industry Act 1993.

Section 6: Declaration and Understanding

I declare that I am the applicant or that I am authorised to
complete this application on behalf of the applicant and that
all statements made in and all matters accompanying this
application are true and correct in every detail and fully
disclose the information required to complete this application.
I make this declaration with the knowledge that it is true
and correct and is made in the belief that a person making
a false declaration is liable to the penalties of perjury.
I declare that the facility named in this application complies
with the required Standards. I will ensure that this facility will
be maintained and operated in accordance with the required
minimum standards during the currency of this licence.
I understand that should the estimated throughput shown
on this form be increased, I will notify PrimeSafe in writing.
The fee payable will be recalculated and I agree that payment
for the difference will be forwarded to PrimeSafe directly.
I authorise and agree to enquiries being made with Victoria
Police and other Australian police forces relevant to Section
14 and 16 of the Meat Industry Act 1993 and information
provided pursuant to those enquiries being used to determine
fit and proper person status for licence issue which may result
in refusal to issue a licence.

Name Signature Date

LIC 2b (10/18)
 Office 150 Albert Road, South Melbourne, VIC 3205
Postal address PO Box 2057, South Melbourne, VIC 3205

Telephone (03) 9685 7333 Facsimile (03) 9696 5284

Email info@primesafe.vic.gov.au
www.primesafe.vic.gov.au

ABN 39 877 327 401

Privacy Statement
PrimeSafe is committed to protecting your personal information consistent
with the principles set out in the Privacy and Data Protection Act 2014.
The complete and latest version of the PrimeSafe Privacy Statement is available
on the PrimeSafe website: https://www.primesafe.vic.gov.au
Collection of personal and other information
PrimeSafe has responsibility for regulating meat, poultry, seafood and pet food
processing standards in Victoria. PrimeSafe’s functions include control and review
of standards for construction and hygiene of processing plants, equipment and
vehicles through a licensing and inspection system and audited quality assurance
programs to ensure standards are maintained. PrimeSafe also has an enforcement
function which includes prohibition of processing, selling or transporting meat,
poultry, seafood and pet food without a licence.
The only personal information held by PrimeSafe is collected from an individual
solely to fulfil the Authority’s functions under the provisions of the Meat Industry Act
1993 and the Seafood Safety Act 2003. Examples of this information are as follows:
• Licence applicant’s name – is not required to be an individual’s name,
could be a company name;
• Postal address – may be a home or business address and is not stipulated
by PrimeSafe;
• Details of convictions to facilitate an assessment under Section 16 of the
Meat Industry Act 1993 and Section 14 of the Seafood Safety Act 2003;
• Complainants details in order to respond to their complaint.
PrimeSafe will not disclose personal information except in the event that disclosure
is required to undertake a law enforcement activity of the Authority or unless legally
required to do so. All personal information is usually collected from the individual
although there are times when personal information may be collected from a third
party and this will usually be in undertaking a law enforcement activity. For example,
a complaint regarding the illegal processing of meat may include the name of the
person undertaking such activity and their place of residence.
Information collected by PrimeSafe is not sold nor used for commercial
marketing purposes.
Security of your personal data
We store your personal information electronically or in hard copy and we
endeavour to protect information from misuse and loss and from unauthorised
access, modification and disclosure.
The protection of personal data is a priority of every employee of PrimeSafe.
All employees of PrimeSafe have a statutory duty to manage your personal
information confidentially (Meat Industry Act 1993, Section 57).
Your right to access and correct personal records
If you believe we hold personal information about you, you can ask for a copy
of your  personal data by writing to us. You can ask us to correct, update or
amend the information we hold about you. Before we send you any personal data,
you will need to provide evidence of your identity. If you do not provide evidence
of your identity, PrimeSafe reserves the right to refuse access to the personal data.
Further information
Please contact PrimeSafe if you would like to:
• obtain further information about this privacy statement;
• access your personal information held by PrimeSafe;
• provide details for PrimeSafe to correct or update your
personal information; or
• complain about a breach of privacy by PrimeSafe.

How to Pay
Please select the payment method below:

BPAY® EFTPOS/cash Cheque or money order

Return the completed application to: Paying in person

PrimeSafe
Payment can be made at PrimeSafe,
Biller code: 125914 PO Box 2057
150 Albert Road, South Melbourne, between
South Melbourne
Ref: VIC 3205
8.30am and 5pm, Monday to Friday.
PrimeSafe accepts payments by EFTPOS
NOTE: BPay payments are only for
or in cash.
renewing licence. Payments
Telephone & Internet Banking - BPAY for new licence applications By mail
cannot be made using BPAY.
Contact your bank, credit union or building Enclose a cheque or money order and mail it,
society to make this payment from your cheque together with your completed application, to:
or savings account (excluding credit cards). PrimeSafe
More info: www.bpay.com.au PO Box 2057
South Melbourne
VIC 3205
Payments to be made payable to ‘PrimeSafe’.

Office Use Only

Payment batch number Date entered

Notes