Prior to commencing your check, please download the Consent to Release Information form, sign it, and date it.

CONSENT TO RELEASE INFORMATION FORM

1. Select your check type from the options available.

2. Upload your signed Consent to Release Information Form

3. Complete and sign the Consent Letter section.

4. Make payment and submit your application to finalise your check.

5. Submit form

Please ensure the completed Consent to Release Information form you upload is clear and legible:

• The entire form must be fully visible, well-lit, in focus, and high quality.

• Your signature and the date must be clearly visible and readable.
  

• Avoid blurry, dark, low-resolution, or crooked images.

• We strongly recommend scanning the form or taking a clear photo in good lighting,

TO WHOM IT MAY CONCERN 

I, the applicant, hereby authorise the VICRoads and Main Roads to provide details of all traffic and licence history records recorded against me to: 

My Representative       Name:  ANGUS ELLIOT

                                           Organisation: ELITE SCREENING AUSTRALIA PTY LTD 

                                           Postal Address: P.O Box 636, Toowoomba City, QLD 4350       

I further authorise and consent to Elite Smithering Pty Ltd (including any authorised employee or representative of Elite Smithering Pty Ltd) receiving the results of the above check by email or other secure electronic means from VicRoads and/or the Department of Transport and Main Roads, and to that authorised person providing a copy of those results to me by email or other agreed method.

Individual’s Declaration and Warranty

I declare and warrant that:

1. I am the person referred to in this Authority to Release Information Consent Letter.

2. All the personal details provided by me are true and correct.

3. I agree for Elite Screening Australia Pty Ltd to collect, use and disclose my personal information (including the traffic and licence history records) in accordance with its Privacy Policy and the Australian Privacy Principles under the Privacy Act 1988 (Cth).

4. I acknowledge and agree to the Elite Screening Australia Pty Ltd terms of use.

5. I authorise Elite Screening Australia Pty Ltd to submit my release of information application form to VicRoads on my behalf.

6. I understand that the information released may include details of any convictions, demerit points, suspensions, cancellations or other matters recorded against me.

7. This consent is given voluntarily and remains current until the check is completed and the results are provided to me, or until I withdraw it in writing (whichever occurs first).

Need help filling out this form?

Please contact our customer service team at the details below:

Web: Contact | Elite Screening Australia

Email: admin@elitescreeningaustralia.com.au

Ph: 1300 959 214

ABN: 73 647 362 203