| 1. Exporter information |
| Licence holder’s name | Provide name of the registered Licence Holder. |
| Export licence number | Provide Export Licence number. |
| Licence expiry date | Provide the expiry date for the Export Licence. |
| Company name | Provide the name of the company that has been licenced to export. |
Approximate date of export | Indicate the expected export date for the consignment if the export permit is issued. |
| Company address | Provide the physical address of the company that holds the Licence. The address must match the address that is listed on the Licence. |
| Postal address | Provide the postal address to which you would like the export permit sent. Permits will be sent by standard mail unless a self-addressed express post envelope accompanies the application. |
| 2. Importer Information |
| Overseas importer’s full name | State the full name of the overseas importing entity. |
| Overseas importer’s address | State the physical address of the overseas importer to be displayed on the export permit (the importing address cannot be a PO Box). |
| Import authorisation No. | Cannabis and cannabis-related substances that are subject to control under the international drug treaties cannot be exported from a country without the prior approval of the competent authority in the receiving country. State the import authorisation number listed on the authorisation issued by the competent authority in the destination country. A scanned copy of the overseas import authorisation must accompany the export permit application submitted to NCS. |
| Import authorisation date of issue | Specify the date the overseas import permit was issued. |
| 3. Cannabis Flower/flos – Only complete if exporting cannabis in flower or bud form |
| Raw Material API or Finished Goods | Select Raw Material API if the cannabis being exported is raw material to be used as an active pharmaceutical ingredient (API) to be further manufactured into a finished product. If the cannabis being exported is a raw material, indicate the total weight (in grams) to be exported. Select Finished Goods if the cannabis being exported is a finished good and requires no further manufacturing. Indicate the pack size and number of packs to be exported for the finished good. |
| Examples: |
Cannabis Flos (or Flower) for export as finished good
|
Cannabis Flos (or Flower) for export as raw material
|
| 4. Cannabis related substances (e.g. extract, oil, THC, Delta-9-THC, CBD) |
| Raw Material API or Finished Goods | Refer to point 3 for the definitions of API and Finished Goods. |
| Origin of cannabinoids | Indicate whether the cannabinoids are of Natural or Synthetic origin. |
| Concentration/Strength | Indicate the concentration/strength of the major cannabinoids - For raw material: Express each cannabinoid as a percentage (%)
- For finished goods: Express each cannabinoid in milligrams per millilitre (mg/ml)
- Wafer/sublingual film: Express each cannabinoid in milligrams (mg)
|
| Form of substance | Indicate the form of the finished goods, for example capsule, cartridge, oil, seed etc. |
| Pack type and size | Provide details on the pack type and the size in metric units only. - API material: for example 1kg pack
- Finished goods (single units): for example 30ml bottle or 15g pack
- Finished goods (multiple units): for example 10mg wafer, pack of 50
- Cannabis seeds: for example 10 packs of 50 seeds
|
| Number of Packs | Specify the total number of packs/bottles (as defined above) that make up the proposed shipment. For example: 20 if you are exporting 20 x 1kg packs 500 if you are exporting 500 x 30ml bottles 1,500 if you are exporting 1,500 x 15g packs 100 if you are exporting 100 x packs of 50 wafers (5,000 wafers total) Net weight of seeds. |
| Examples: |
THC/CBD for export as finished goods
|
Samples for laboratory use for export
|
Seed for cultivation for export
|
5. Declaration and Consent Make sure you read and understand the declaration and consent. Sign the application form. Complete the contact details of the person signing the form. The form must be signed by the licence holder or a person that the licence holder has authorised in writing to make applications under the licence. |
