FORM A
NOTICE OF INTENTION TO
RELINQUISH JETTY LICENCE
When you sell your property, please complete this form and submit to:
Maritime Licensing Officer
Department of Transport
Facilities Management
1 Essex Street, Fremantle; or PO Box 402 Fremantle WA 6959; or
Facsimile: 9435 7808; or Email: patricia.manyam@transport.wa.gov.au
I
of
(Print name of vendor)
have sold/am selling
to
(Print name of purchaser)
(Address)
at
(Jetty number)
(Location of jetty)
of
(Postal address)
Settlement Date__________________
Purchaser’s telephone number/s:
Please also complete the following:
I CONFIRM THAT:

THE JETTY HAS NOT BEEN ALTERED IN ANY WAY WITHOUT THE DEPARTMENT OF
TRANSPORT’S WRITTEN CONSENT; AND

THE JETTY NUMBER IS DISPLAYED ON THE JETTY.
____________________________________________
Vendor’s signature
____________________________________________
Purchaser’s signature
NB: Clause 1(g) of your licence agreement states that you are to display the licence number
allocated for that purpose on such part or parts of the jetty so as to be clearly visible from
the shore and the water. It should be displayed so that it is well above winter high-water
level and should have figures at least 75 millimetres in height.
Application to transfer a jetty licence, received after the property sale, will be processed as normal
but, should approval for transfer not be given for any reason, the repair or removal of the structure
may remain the previous owner’s responsibility (particularly if located on a public foreshore).
Therefore, before selling a property with a jetty, you should ascertain whether:


all licence fees in arrears have been paid; and
the facility is in a good and safe condition.