This form is to be used to pay the fee to place a licence on hold, pursuant to r4A of the Real Estate and Business Agents (General) Regulations 1979 and the Settlement Agents Regulations 1982

This form can ONLY be accepted in person or by post. It cannot be accepted by email to protect your credit card details.

Please complete this form and return it to:

By mail:

Business Licensing
Department of Energy, Mines, Industry Regulation and Safety
Locked Bag 100
East Perth WA 6892 

In person (between 8:30am – 4:30pm weekdays):

Business Licensing
303 Sevenoaks Street
​Cannington WA 6107