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picture1_Certificate Word Format 30149 | Cc 9 Local Knowledge Certificate Application


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File: Certificate Word Format 30149 | Cc 9 Local Knowledge Certificate Application
cc 9 august 2020 application for a local knowledge certificate marine safety act 2010 vic marine safety regulations 2012 vic things to know before applying a master of a domestic ...

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                                                                            CC 9
                                                                            August 2020
           Application for a local knowledge certificate
           Marine Safety Act 2010 (Vic), Marine Safety Regulations 2012 (Vic)
           Things to know before applying
           A master of a domestic commercial vessel who is a holder of a certificate of competency as deck crew 
           may apply for the issue of a local knowledge certificate. Holders of engineer level certificates of 
           competency are ineligible.
           Applicants should refer to the Local Knowledge Certificate: Determination for Masters of Domestic 
           Commercial Vessels (Local Knowledge Determination) for the specific requirements of some local 
           knowledge areas.
           Further information regarding local knowledge areas can be obtained from the relevant Harbour Masters 
           and the following registered training organisations: Federation Training (for south-eastern areas); and 
           Marine Training Services (for Melbourne and Geelong). The accredited training organisations may offer 
           practical familiarisation and training in some of the local knowledge areas.
           Supporting documents
           This form provides the information needed to apply for a local knowledge certificate. Applicants are 
           required to demonstrate/provide evidence of training attendance, course completion and sea service 
           requirements. For some applications, copies of supporting documents are required. 
           Fees and payment
           The fee payable depends on the type of application and how many local knowledge areas are required. A
           local knowledge certificate cannot be issued until applicants have paid all fees.
           Oral examination
           Applicants do not need to complete an oral examination prior to submitting an application for a local 
           knowledge certificate. Maritime Safety Victoria (MSV) will notify applicants in writing regarding the 
           conduct of their oral examination once their application has been assessed. 
           It is expected that applicants are well prepared and have a detailed knowledge of the area(s) in which 
           they are applying for local knowledge certificates prior to attending an oral examination. Local knowledge 
           certificate examinations include assessment of the applicant’s knowledge of navigational aids, 
           geographical features, statutory requirements, marine traffic and other local characteristics, operational 
           condition or anomaly which may relate to safety of navigation.
           Attachments
           As part of the application you must attach the following supporting documentation:
              certified copy of your current certificate of competency.
              certified copy of photographic proof of identity (e.g. current passport or driver licence).
              one passport size photo (approximately H45mm x W35mm) Photos must be less than 12 months 
              old, 
              completed Local Knowledge Port Office Notice of Attendance (Attachment 1)
           If you are applying for a local knowledge certificate for Passenger Operations through Port Phillip 
           Heads or across the Lakes Entrance Bar
              a certified copy of a course completion certificate issued by a registered training organisation (RTO) 
              or an accredited training provider (ATP) dated within the last twelve month period immediately 
              preceding the receipt of the application showing successful completion of the relevant training.
            Maritime Safety Victoria
            A branch of Transport Safety Victoria
            PO Box 2392, Melbourne Victoria 3001 T 1800 223 022 F 03 9655 6611
            E information@transportsafety.vic.gov.au transportsafety.vic.gov.au/msv
                  How to lodge 
                  Send your completed application and any attachments to TSVqualifications@transportsafety.vic.gov.au or
                  by post to Maritime Safety Victoria, PO Box 2392 Melbourne VIC 3001.
                  What happens next?
                     If the form is completed correctly and all necessary documents are attached, allow four (4) weeks for 
                      processing.
                     If requested by MSV, you must provide further information.
                     If there are any change to the required information after you have applied, you must notify MSV as 
                      soon as possible.
                     MSV will write to you advising of the next steps.
                  Please contact MSV at TSVqualifications@transportsafety.vic.gov.au or on 1800 223 022 should you 
                  have any questions regarding this application.
                  Privacy
                  It is an offence under the Marine Safety Act 2010 (Vic) to give information that is false or misleading in 
                  order to obtain or attempt to obtain a certificate. Maritime Safety Victoria, a branch of Transport Safety 
                  Victoria (TSV) collects and holds the personal information provided in this application to assist the 
                  Director, Transport Safety (Safety Director) to administer the Marine Safety Act 2010 (Vic) and Marine 
                  Safety Regulations 2012 (Vic). TSV is committed to protecting personal information in accordance with its
                  obligations under the Marine Safety Act 2010 (Vic). The personal information provided in this application 
                  may be disclosed to other government agencies in accordance with section 306 of the Marine Safety Act 
                  2010 (Vic) and section 177 of the Transport Integration Act 2010 (Vic). The individuals whose personal 
                  information is collected on this application have a right to seek access to this personal information and to 
                  seek correction of any error in the personal information held. All individuals whose personal information is 
                  included with this application should be informed of this fact. For more information on privacy please refer 
                  to TSV's privacy statement at transportsafety.vic.gov.au/privacy.
                  CC09 – 08/2020
                  DOC/20/260839                                                                                                       Page 2 of 8
              Application for a local knowledge certificate
              Marine Safety Act 2010 (Vic), Marine Safety Regulations 2012 (Vic)
              Applicant details
              1.  Do you currently hold a certificate of competency?
                       No  You are ineligible to apply for a local knowledge certificate until you hold a certificate of competency. 
                               Please do not continue with this application. For further information contact MSV at 
                               TSVqualifications@transportsafety.vic.gov.au or on 1800 223 022.
                       Yes  What type of certificate of competency do you hold?
                     Grade/Class                                                             Issuing authority        Expiry date
                                                                                                                        
              2.  Surname                                             Given names
                                                                            
              3.   Date of birth (dd/mm/yyyy)     City or town of birth                  State          Country      Australia or specify
                                                                                                             
              4.  Residential address
                  Street number and name
                          
                  Suburb                                                                             State              Postcode
                                                                                                                             
              5.   Postal address
                       Same as residential address 
                   OR Street number and name/PO Box
                          
                   Suburb                                                                            State              Postcode
                                                                                                                             
              6.   Mobile number                                   Daytime telephone number
                                                                       Same as mobile or (     )      
                   Email 
                          
              Type of certificate
              7.   For what State waters are you seeking a local knowledge certificate?
                   Choose all that apply (Please note the additional requirements for areas marked with an asterisk)
                       LK.3 *  Port of Corner Inlet – Including Toora and Barry Beach Channel to Barry Beach, but Excluding 
                               Lewis Channel and Port Welshpool (LK4) and Port Albert (LK5)
                       LK.4 *  Port of Corner Inlet – Including Lewis Channel and Port Welshpool, but Excluding Toora and Barry 
                               Beach Channel to Barry Beach (LK3) and Port Albert (LK5)
                       LK.5 *  Port Albert and Approaches – Including the Port Albert Bar and Port Albert Channel
                       LK.6    Geelong – West of an imaginary line north/south on Longitude 144o 40’E Including Corio Bay, the 
                               Outer Harbour and sections of Port Phillip Bay
                       LK.8 - Lakes Entrance and Approaches – includes sections of The Narrows, Reeve Channel, Hopetoun 
                               Channel and Cunninghame Arm
                       LK.8 *  Lakes Entrance and Approaches, - Passenger Carrying vessels - Including Lakes Entrance Bar and 
                               sections of The Narrows, Reeve Channel, Hopetoun Channel and Cunninghame Arm
                       LK.8 *  Lakes Entrance and Approaches – Non-Passenger Carrying vessels - including Lakes Entrance Bar, 
                               sections of The Narrows, Reeve Channel, Hopetoun Channel and Cunninghame Arm.
                       LK.15 *Port Phillip Heads - Passenger Operations through Port Phillip Heads – Including the adjacent waters
                               inside Port Phillip Heads
                       LK.16  Port Phillip Bay, South
                       LK.18  Port Phillip Bay, North
                       LK.19  Lower Yarra River – Bolte Bridge to Dights Falls
                       LK.20  Western Port and Hastings - Western Waters
                       LK.21  Western Port - Eastern Waters
                   * Refer to the Local Knowledge Determination for additional sea service/course requirements
                   Please outline any additional information regarding your training and/or experience that will be relevant to the 
                   local knowledge area(s) you are applying for
                                                                                                                                                                                                                
                                                                                                                                                                                                                
                                                                                                                                                                                                                
                                                                                                                                                                                                                
                                                                                                                                                                                                                
              8.   Are you seeking a local knowledge certificate to operate a vessel of 35m and over in pilot required waters?
                   Please note: All local knowledge certificates may be subject to conditions deemed appropriate. Section 83 (2) 
                   of the MSA allows the Safety Director to impose conditions on certificates issued. Applicants should refer to the 
                   Local Knowledge Determination for the specific requirements of some local knowledge areas.
                       No 
                       Yes  Please provide details of the area of proposed operation and vessel details (name, length, etc.) 
                   below:
                                                                                                                                                                                                                  
                                                                                                                                                                                                                  
              CC09 – 08/2020
              DOC/20/260839                                                                                                     Page 4 of 8
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