Filming Permit Application Form

Company Details

Company/Applicant Name (responsible for the filming)

Does the company name match the name insured on the public liability insurance (PLI)?

Yes
No

Please note: A permit will not be issued without current PLI

Please provide more information

Contact details

Name

Position / Title

Phone

Email

On-site contact on day of filming

name (e.g. /

Name

Position/Title

Phone

Email

Production Information

Project Name

Production Type

Please specify name of program:

Please specify:

How will this project be distributed? (e.g. online, television, cinematic release)

Proposed Filming Dates

From

To

Alternate Filming Dates

From

To

Filming Times (including bump-in and bump-out times)

Location Information

Exact location/s of the proposed filming

Please provide a brief summary or synopsis of the scene and/or activities and why you have chosen NGV as the location to film this

Number of cast on location

Number of crew on location

Will the production need a unit base?

Yes
No

Please add your unit base to your site plan/mud map to the attachments at the end of this document

Exact location/s of the proposed unit base? (Including any privately owned land.)

Unit base times (start/finish)

Will the production erect any temporary structures such as tents or marquees at the unit base?

Yes
No

Please provide details of these temporary structures (size, number, style) Please note: temporary structures need to be secured by weights, not pegs or stakes.

Will the production require traffic management or pedestrian management? Please note: If the production is disrupting traffic or pedestrian flow a Traffic Management Plan (TMP) or Pedestrian Management Plan (PMP) Incorporating a Risk Management Plan will be required.

Yes
No

Type of activity (e.g. hold & release, road closure)

Name and details of the traffic/safety company who will be supplying the TMP or PMP?

What times will the roads be affected?

Start of closure

Finish of closure

Name of the roads affected by the closure/traffic hold?

Details of any large equipment the production will bring to the location (e.g. camera cranes, scaffolding, lighting towers)

Please indicate if the production will involve any of the following:

*Confirmation of approval from Victoria Police or other state government agencies will be required with this application.

Provide details of activity

Will the proposed filming represent the actual location?

Yes
No

Please identify the location the filming will represent

Required Documentation

Please include the relevant documentation for your production. If the documentation is unavailable to be sent at this time please indicate via email the date on which it will be sent.

Public liability insurance