Step 1 of 3

Step 1. Provide Business Details

Registered Business Name(Required)

Trading Name(Required)

Business ABN/ACN(Required)

Website URL(Required)

Business Street Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Is your postal address same as your business address?(Required)

Yes

Other

Business Contact Person(Required)

First Name Last Name

Email(Required)

Business Phone(Required)

Business Mobile(Required)

Step 2. Provide Details of Nominated Foreign End Markets for Verification

Same as Business Details (Step 1)(Required)

Yes (if yes, move to 'Sign Off & Submit' on next page)

No (if no, please provide business details below)

Provide Business Details of your nominated foreign end market destinations that you wish to commence verification process below:

Supplier Name

Address

Contact First Name

Contact Last Name

Contact Email Address

Contact Phone Number

Type of facility: e.g. retread, mechanical processing (shredding/crumbing), pyrolysis or other (please describe)

(Click the + to add multiple suppliers)

Step 3. Sign Off & Submit

Please check the following details and acknowledge that you agree to participate in the FEM verification program:(Required)

I have read the FEM information on TSA’s website and agree to participate or organisations that I have nominated are aware of request to participate in the verification process, such as for the purpose of export licencing requirements

I agree to making payment for the verification process (as delegated to me) for own facility or those nominated by me (as above)

I understand that required payment for verification steps will be invoiced to me offline (by Intertek) and verification process cannot proceed without payment being made (in full)

I agree that upon receiving notification of verification status locations are made aware of any conditions, such as resolution of corrective actions and annual completion of SAQ to maintain verification status – as per TSA advise & communication

I agree that no warranty around completeness or accuracy of the information which is provided on nominated facilities via this program

Where request for verification is to satisfy requirements of export licencing process, I agree to TSA sharing information on locations participating in the program and verification status with the Department of Agriculture, Water and the Environment

Name of Company CEO/Director or equivalent (registering for FEM verification)(Required)

First Name Last Name

Contact Phone(Required)

Contact Mobile Number(Required)

Email(Required)

Agreement(Required)

I agree that my details will be saved for essential contact from Tyre Stewardship Australia

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Foreign End Market Verification - Registration Form

Step 1. Provide Business Details

Step 2. Provide Details of Nominated Foreign End Markets for Verification

Step 3. Sign Off & Submit