AVS CHARGE & CREDIT CARD AUTHORISATION FORM

Payment must be in New Taiwan dollars. No other currency will be accepted. Payment
can be made by Visa, MasterCard or JCB credit card.

The fee is payable when the application is submitted. Applications submitted without the
fee payment will be returned to the applicant unprocessed.

Charge/Credit Card Authorisation:

I wish to pay my processing fees by

Visa            MasterCard            JCB

Card Number __________________________          Expiry date (MM/YY) ___________

The total payable fee is NT$ _____________. I authorise the Australian Commerce &
Industry Office, Taipei to charge this amount to my nominated credit card.

Details of Cardholder

Cardholder's name: ___________________________________   Tel.No. (Day time): ______________

Address: _________________________________________________________________
              _________________________________________________________________
              _________________________________________________________________

Signature                                                                             Date: _____/_____/_____
Of Cardholder: ________________________________                        (day/month/year)

IMPORTANT: Please ensure that your signature is identical to that which appears on 
your card.

Name of applicant:

File number: