Form for Representatives of applicants and licensees. Form for Representatives of applicants and licensees 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Annex 1: Fill in the Applicant Authority information, including your name, title, and contact details. Ensure that you provide accurate information as this section identifies the authorized representative.
3. Complete the attestation statements by checking each box to confirm your understanding and agreement. This is crucial as these statements are binding on the applicant or licensee.
4. Proceed to Annex 2: In Section A1, enter the details of the Radiation Safety Officer, ensuring their authority is clearly stated. In Section A2, list any additional representatives authorized to act on behalf of the applicant or licensee.
5. Finally, as the Applicant Authority, sign and date Section B to authorize those listed in Section A. Review all entries for accuracy before submission.

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