Registration of a mobile food vending vehicle (Private Land)

The Food Act 2003 requires all mobile food and drink businesses operating within the Canterbury Bankstown Local Government Area to be registered with Canterbury Bankstown Council. This registration form is to be used by operators in order to register their mobile food and drink business or to change any registration details.

If you have any questions in regards to this form, please contact Council’s Environmental Health Unit on (02) 9707 9000.

Applicant Details

Proprietor Name: *

Contact Number *

Email *

Property Details

Location of Mobile Food & Drink Business

Business/Trading Name: *

Address *

Street Number:

Street Name: *

Suburb *

Postcode *

Other location details:

Business Details

Where all correspondence and invoices will be sent

Company Name: *

ACN/ABN: *

Contact Person: *

Contact No. *

Postal Address:

Email: *

Other Details

Business Trading Hours: *

Day time onlyDay and nightNight time only

Reason for submitting this form: *

New premisesChange of proprietorUpdate details

Date business was opened or ownership changed:

Type of Food being Sold

Please specify: *

Food storage details

Please provide details of food storage: *

Food Safety Supervisor Details

Food Safety Supervisor's Name:

Certificate Reference No.

Certificate Expiry Date:

Details of waste storage/removal

Please specify the details of the waste storage/removal: *

Owner's Consent

Have you obtained the consent of the owner of the property on which the mobile food and drink business is to trade? *

YesNo

Owner's Details

Owner's Name: *

Contact No

Owner's Email *

Owner's Signature *

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Date:

Note: Registration of your business does not imply development consent nor does it imply approval of the construction or fit out of the premises for proposed/additional/alternate uses.

Privacy Statement

In submitting this form, you consent to Council:

Collecting your personal information as contained in the form; and
Using the information for the purposes outlined in the form.

Providing your information is voluntary. Should you choose not to provide the information, Council is unable to process your application/request.

You may access any of your personal information that Council holds upon request.

Applicant Declaration

I declare that to the best of my knowledge, the information provided in this registration form is accurate and correct. *

Proprietor Signature *

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