For the purposes of section 191ZZA of the Act, an application for a work diary exemption must include the following information—
(a) the driver's full name, address and driver licence number;
(b) the address of the driver's base and record location;
(c) the full name and address of the driver's nominee under section 191ZZA(3)(b) of the Act;
(d) the grounds for seeking the exemption, together with documentation to support the grounds for the exemption;
(e) the period for which the exemption is sought;
(f) any conditions to which the exemption is sought to be subject.