Exemption Applicationform Peer Passenger Restriction

5/26/2018 Exemption Applicationform Peer Passenger Restriction

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Peer Passenger Restriction Exemption Application

Version 2, November 2009

Road Safety (Drivers) Regulations 2009 regulation 61---------------------------------------------------------------------------------------

This form is to be used by a probationary (P1) driver who needsto drive with more than one peer passenger and wishes toapply for an exemption.

Exemptions will only be granted where undue hardship by theapplicant can be proven and VicRoads is satisfied that roadsafety is not compromised. Any exemption granted will berestricted and conditional.

Any exemption granted may result in conditions imposed on thepersons driver licence for a specif ied period which:

(a) limit the carriage of peer passengers; and/or(b) limit routes of travel when carrying peer passengers;

and/or(c) restrict driving to specified times of the day when

carrying peer passengers; and/or(d) restrict driving to specified days of the week when

carrying peer passengers.

THIS REGULATION DOES NOT APPLY and NO EXEMPTIONIS REQUIREDfrom VicRoads if the probationary driver:- is a member of the police force and is driving a motor

vehicle in the course of his or her duties; or- is driving an emergency vehicle in the course of his or her

employment or duties, or in accordance with any terms ofcontract or any engagement, or driving in an emergencyproviding emergency transport to hospital; or

- has an experienced driver sitting beside him or her; or- peer passenger(s) is (are) their spouse, domestic partner,

and/or sibling(s) (see below for further information).

Note: The experienced driver must be a supervising driver whoholds a full driver licence which authorises the person to drive

that motor vehicle.

What is the Peer Passenger Restriction?

The Peer Passenger Restriction is where a probationary (P1)driver is not allowed to carry more than one peer passengerwhen driving.

A peer passenger is any person aged between 16 and less than22, but does not include the drivers spouse, domestic partner,sibling or step-sibling.

The legal definition of each has been detailed below:

- spouse a person to whom the person is married;

- domestic partner a person to whom the person is notmarried but with whom the person is living as a couple on agenuine domestic basis (irrespective of gender);

- siblings brothers and sisters (including step and fosterrelationships).

Who is eligible to apply for an exemption?

To be eligible to apply for an exemption, you must already hold aprobationary (P1) drivers licence.

When should an exemption be applied for?

An application for an exemption should onlybe made when theprobationary (P1) driver can demonstrate to VicRoads, byproviding supporting documentation, that he or she and/or theirimmediate family will suffer undue hardship as a result of thepeer passenger restriction due to the nature of the probationarydrivers employment, essential activities or family circumstances.

What documentation must be provided?

To support the application, the probationary (P1) driver mustprovide: documentation from his or her employer verifying the

employment if the exemption is required due to hardship asa result of employment circumstances; and/or

documentation from a relevant authorising person orinstitution if the exemption is required due to hardship as aresult of essential activities or family circumstances.

Please ensure that the person supporting your applicationalso completes Section 9 of this form - Supportingpersons details.

This completed application must be mailed to:

VicRoadsExemptions53 61 Lansell StBENDIGO VIC 3550

VicRoads reserves the right to cancel your exemption ifyour driver licence is cancelled or suspended. A letter willbe sent to you to advise you of VicRoads intention tocancel the exemption, and you will be allowed anopportunity to show why you should be permitted to retainthe exemption. If you do not respond to the notice withinthe required time, the exemption will be cancelled without

further notice.

VicRoads Probationary Licence No.:

NOTE

The personal information that you provide on this form willbe used by VicRoads to assess your application for anexemption under regulation 61(3) of the Road Safety(Drivers) Regulations 2009. Failure to provide theinformation may result in your application not beingprocessed.

The personal information we collect from you inassociation with your application may be used only inaccordance with the Road Safety Act 1986 and associatedRegulations or as otherwise required by law. Your personalinformation may be disclosed to contractors and agents ofVicRoads, law enforcement agencies or Courts authorised

to collect it.

For further information about our use of your personalinformation and your right of access to it, please see theVicRoads document Protecting Your Privacy or contactVicRoads on 13 11 71.


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1. Probationary Licence details

Probationary Licence Number

2. Applicants details

Family name (please PRINT)

Given name/s (please PRINT)

Date of Birth

Residential address (please PRINT)

Postal address (if same as residential write AS ABOVE)

Daytime contact phone number

3. Employment travel details (Not self employed)

(To be completed if you need to drive more than one peerpassenger to or from your place of employment, or as part ofyour employment)

Employers name (please PRINT)

Employers address (please PRINT)

ABN (Australian Business Number) Occupation

What are the times during the week and days of the week thatyou are expected to carry more than one peer passenger?(Please give an example of a typical working week)

Fromam/pm

Toam/pm

Days of the week

Note:A letter from the employer confirming these times must beprovided.

What public transport or other means of travel is available to you fortravelling to and from your place of employment, or as part of youremployment?

How many kilometres do you travel both waysto get to your place of employment?

4. Employment travel details (self employed)(To be completed if you are self employed and need to drive more

than one peer passenger to and from employment)

Entity/Trading name (please PRINT)

ABN (Australian Business Number)

Entity/Trading address (please PRINT)

Occupation

What are your start and finish times for each day of the week andthe days of the week that apply?(Please give an example of a typical working week)

Fromam/pm Toam/pm Days of the week

Could you use pubic transport or other means of travel as part ofyour employment?

Yes No

What public transport or other means of travel is available to you fortravelling to and from your place of employment?

How many kilometres do you travel both waysto get to your place of employment?

km


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5. Essential activity and family circumstance travel details(To be completed if you need to drive one or more peerpassengers to and from certain locations due to other essentialactivity or family circumstances)

Please explain the essential activity or family circumstancewhich involves you having to drive the peer passengers.

What is the address to which you need to travel?

How often are you required to travel to this location? (daily,weekly etc)

What are the usual times at which you are required to travel tothis location?(Please give an example of a typical week)

Times (am/pm)

Mon Tues Wed Thur Fri Sat Sun

Note:A letter from a relevant person (eg medical practitioner,parish priest etc) confirming these times must be provided.

What public transport or other means of travel is available fortravelling to get to this location?

How many kilometres do you travel one wayto get to this location?

Please list the names, DOBs and addressesof additional peerpassengers requiring transport, their relationship to you andreasonsfor why these passengers require transport by you.

.

6. Affect on employment/ essential activity/ familycircumstances and severe hardship that may be caused

Please outline below:- how the peer passenger restriction would affect

employment/essential activity/family circumstances

- what undue hardshipmay be caused to you and your familyif this application is refused?

(Attach a separate sheet if required)

7. Checklist

To ensure your application is processed promptly, please makesure that you have included the appropriate documents in support

of this application as outlined in this form under, Whatdocumentation must be provided?

8. Declaration

I declare that the information I have provided in this application iscomplete, true and correct in every detail. I understand that failureto provide complete, true and correct information in thisapplication may result in my application being refused.

I authorise VicRoads to make any enquiries considerednecessary for the purpose of this application.

Applicants signature

Date

km


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9. Supporting persons details (eg employer, educationalinstitution, medical practitioner etc) Accompanyingdocumentation must be provided by this person.

Full name (please PRINT)

Residential address (please PRINT)

Daytime contact number

Name of organisation (Business, educational institution,medical treatment provider etc - Please use stamp if available)

Supporting persons title (manager, registrar, treating doctor etc)

Do you have any other information about the applicantscircumstances that you consider important for VicRoads toconsider when assessing this application?

No Yes

If yes, please provide a signed statement on yourorganisations letterhead.

I give permission to VicRoads to contact me for furtherinformation considered necessary for the purpose of thisapplication.

I undertake to give any further information that VicRoads mayask to verify any statements made by me in this application.

I declare that I support this application and that, to the best ofmy knowledge, the information given by the applicant iscomplete, true and correct.

Supporting persons signature

Date

Office Use Only

Office Stamp/application received:

Decision

Document/File ID

Do you approve of this application?

No Yes

Reasons for decision

Delegated persons name

Position/ Title

Signature

Date

Documents

Exemption Applicationform Peer Passenger Restriction