Once submitted, this Standard Data Order Form will form part of the Standard Data Licence Agreement. Customer Details Organisation Name (if applicable) Selected Product Groups Order total = $0.00 Note: Additional user fees or royalties may be payable Street Address Street Address is required City/Suburb City/Suburb is required State/Province State/Province is required Zip/Postal Code Zip/Postal Code is required Country Country is required Existing Customer # (if applicable) ABN/ARBN (if applicable) Customer Contact Name Client Contact is required Customer Contact Position Contact Phone is required Email address An email address is requiredInvalid email address format Phone Number Phone Number value is required Fax Number What business do you undertake? Will the Standard Data be used for personal or internal business uses only? (Additional per user fees may be payable) Yes No Will you be distributing (either for free or for a price) the Standard Data to any third party (i.e. any person who is not an employee of the organisation)?(Your answer to this question will be dictated by your answer to the previous question. Note also that royalties or additional per user fees may be payable) Yes No Please indicate your approximate number of actual or potential end users of the Standard Data (Additional per user fees may be payable) Will the Standard Data be used in a product or service? Yes No How will you use the Standard Data? If you are redistributing any part of the Standard Data, please state to who and for what purpose. Will you use or incorporate some or all of the Standard Data in a product or service that will/can be used for air navigation? If yes, please provide details. Please provide a product name or identifier and brief description of your product / service that will incorporate the Standard Data. What is the customer base / target market for your product / service that will incorporate the Standard Data? How will your end users use the product / service that will incorporate the Standard Data? Please include any extra information that will clarify or support your Order. Is the Customer (organisation or individual) a resident in Australia for tax purposes? If not, you must complete the Confirmation of GST Treatment Form. Please note: If you do not complete the Confirmation of GST Treatment Form Airservices will assume that data transactions will attract GST, and you will be charged accordingly. Yes No Please make a selection. I have read and agree to the Standard Data Licence AgreementStandard Data Licence Agreement on behalf of myself and the Customer and I represent, and I warrant that I have due authority to bind the Customer to the Standard Data Licence Agreement. I acknowledge that depending on the use of the Standard Data, additional user fees or royalties may also be payable under the Standard Data Licence Agreement. I Agree to the Standard Data Licence Agreement to the Standard Data Licence Agreement * You must agree to the Licence Agreement to proceed. A copy of the Licence Agreement, Order Form and GST Form (if applicable) will be emailed to you once all forms are completed and submitted to Airservices. Note that your request may take up to three weeks for assessment and response from Airservices.