FormResponseUUID

IMPORTANT!

Please click on the buttons below and read the information provided before proceeding with filling out this form.

INFORMATION ABOUT THIS FORM IDENTITY DOCUMENT GUIDE

Please read this before completing this application.

You may request a volunteer check if you:

(a) will hold a position or perform a role on a voluntary basis for charitable purposes which have a public benefit where you will not be an employee or contractor and will not be entitled to any salary or other entitlements associated with the position or role, other than payment of out of pocket expenses; or

(b) are a student undertaking a compulsory unpaid vocational placement as part of a training course requirement from an Australian-based educational institution.

The Volunteer check type must not be selected for the Australian Government’s Work for the Dole Scheme.

You must be able to validate the Not-for-Profit organisation and the volunteer position to support your selection of the volunteer type.

CONTACT DETAILS

You can contact the accredited body for more information on the nationally coordinated criminal history check process, how your information is handled and how you can dispute your result through the accredited body.

Accredited Body

Contact Details

Address: P.O Box 636 Toowoomba City QLD 4350
Email: admin@elitescreeningaustralia.com.au
Phone: 1300 959 214

Let's get started with your current FULL NAME

All known names:

You must disclose all names you have been known by through out your life, including your full legal name, name before marriage (maiden name), and other previous names and/or alias names. All names that you submit as part of your nationally coordinated criminal history check, will appear on the check result. If you are concerned about the disclosure of previous name, please contact the accredited body.

With each additional name you provide, you must include your family name, first given names and other given names (ifapplicable).

Example: When Lucianne was born, she was given the first name Lucianne,second given name Jane and surname of Jones. When she was married, she changed her surname to Smith. Lucianne commonly uses the name Lucy when introducing herself in the community.

As such, Lucianne has four known names—her current name, maiden name, the alias name she used before she got married andthe alias name she uses now. Lucianne needs to provide all fournames when completing this form, as follows:

Current name: Smith, Lucianne Jane Maiden name: Jones, Lucianne Jane

Alias name: Smith, Lucy Jane Previous name: Jones, Lucy Jane

Single Names

A single name is where your name comprises of:

•only one word; or

•several words not using Western naming conventions (as per your commencement document).

Example:

• Angel - with no other name

• Mohammed Rasheed Khan – consists of several words that are not documented with a specific first name, middle name, and family name.

First Name: (legal name)

Other Name/s:

Surname:

Name Type: *

Birth/MaidenMarriedAliasOther

Single Name:

What is your CONTACT phone number?

Contact Phone Number: *

What is the check type?

Please choose your check type *

What is the PURPOSE of the CHECK you need?

CHECK CATEGORIES/PURPOSE

The purpose for your nationally coordinated criminal history check helps determine what police information is disclosed on your result

Employment – Paid or unpaid work. Unpaid work is when you are not paid however an employment type relationship exists, for example an internship or work experience.
Probity – Representing yourself as a “fit and proper” person, such as, for membership and tenancy applications
Licence - Undertaking licensed or regulatory activities, such as applying for a gaming licence or for registration as a greyhound trainer.
Commonwealth - Engaged by the Commonwealth but residing outside of the ACT, for example being engaged by Services Australia but residing in WA.

What reason do you need this police check for: *

Please provide clear details for your CHECK TYPE...

For this question provide the following information:

Note: Acronyms must not be used.

Position title, occupation, volunteer role, entitlement being sought or licence type.

Example: Case worker

Example: Volunteer in canteen

Occupation/Position Title, volunteer role, entitlement or licence type *

What is your proposed place of work?

Proposed place of work (name of organisation/ department) or requesting organisation or issuing authority *

Enter the name of the organisation where you will be working,

Examples include:

Coles
Black & White Cabs
YMCA
Link SA
Subway

Where is your WORK LOCATION of the role (town and state/territory).

Suburb/Location: *

State/Territory: *

PREVIOUS NAMES:

Do you have any other previous known names? *

YesNo

Tell us the details of all your PREVIOUS NAMES:

Previous First Given Name(s): *

Previous Other Given Name(s):

Previous Family Name: *

Name Type: *

Birth/MaidenMarriedAliasPrevious

Do you have any other previous known names? *

YesNo

Previous First Given Name(s): *

Previous Other Given Name(s):

Previous Family Name: *

Name Type: *

Birth/MaidenMarriedAliasPrevious

Do you have any other previous known names? *

YesNo

Previous First Given Name(s): *

Previous Other Given Name(s):

Previous Family Name: *

Name Type: *

Birth/MaidenMarriedAliasPrevious

Do you have any other previous known names? *

YesNo

Previous First Given Name(s): *

Previous Other Given Name(s):

Previous Family Name: *

Name Type: *

Birth/MaidenMarriedAliasPrevious

Do you have any other previous known names? *

YesNo

Previous First Given Name(s): *

Previous Other Given Name(s):

Previous Family Name: *

Name Type: *

Birth/MaidenMarriedAliasPrevious

Do you have any other previous known names? *

YesNo

If you have other previous names that you have not already entered above, please keep a record of these as we may need to ask you for this information.

If you have any concerns about this please contact us.

How do you identify your GENDER?

You must select the gender that best describes how you identify yourself within the community.

The gender details that you submit as part of your nationally coordinated criminal history check, will be the gender that appears on the check result.

The ACIC’s processes are aligned with the Australian Government Guidelines on the Recognition of Sex and Gender. If these Guidelines affect you and you would like additional information specifically regarding this, please contact the ACIC directly at npcs@acic.gov.au

Gender *

MaleFemaleAnother Term

Please Specify

BIRTH DETAILS:

If you cannot provide all these details, contact the accredited body or its legal entity customer.

Are you 18 years old or over? *

YesNo

If you are under the age of 18, you will need to have a parent or legal guardian provide their consent for you to perform a police check.

Your parent or legal guardian will need to sign their name in the 'Consent' section further along in this form.

PLEASE ENTER YOUR Date of Birth

Your date of birth: *

Where were you BORN?

Your Place of Birth (Suburb/town): *

Your Birth State/Territory: *

Your Birth Country: *

What is your CURRENT ADDRESS:

Current Residential Address *

Date you started living here: *

Is this your POSTAL address? *

YesNo

Postal Address: *

Date From:

Date To:

Provide your current and previous residential addresses for the past FIVE YEARS.

If you cannot provide full details, provide as much information as possible. If you are unsure how to complete this section contact Elite Screening Australia - admin@elitescreeningaustralia.com.au or Ph: 1300959214

Do you have any other previous addresses in the last five years? *

YesNo

What are all your previous addresses in the past 5 years?

Previous residential address: *

Date you started living there: *

Date you stopped living there: *

Do you have any other previous addresses in the last five years? *

YesNo

Previous residential address: *

Date you started living there: *

Date you stopped living there: *

Do you have any previous addresses in the last five years? *

YesNo

Previous residential address: *

Date you started living there: *

Date you stopped living there: *

Do you have any previous addresses in the last five years? *

YesNo

Previous residential address: *

Date you started living there: *

Date you stopped living there: *

Do you have any previous addresses in the last five years? *

YesNo

Previous residential address: *

Date you started living there: *

Date you stopped living there: *

Do you have any previous addresses in the last five years? *

YesNo

If you have other previous addresses in the past 5 years that you have not already entered above, please keep a record of these as we may need to ask you for this information.

If you have any concerns about this please contact us.

INFORMED CONSENT - CONFIRM & PROVIDE YOUR SIGNATURE

What is Informed Consent?

Your Informed Consent is needed before an Accredited Body can request a Nationally Coordinated Criminal History Check for you.

Your Informed Consent means you:

• have read and understood the information provided in this form about how your personal information and any police nformation relevant to you will be handled and disclosed

• provide your permission for the Accredited Body to request a Nationally Coordinated Criminal History Check on your behalf

• provide your permission for the Accredited Body to disclose your information to any organisation listed in D1 of this form

How do I provide my Informed Consent?

An important aspect of providing informed consent is that you understand what you are consenting to. It is important that you read the consent statements below and, where required, get clarification from the Accredited Body or its Customer, to ensure complete understanding. You must then sign and date this form, to give your Informed Consent.

Accredited Body Details - Organisations to whom the applicant’s personal and police information will be disclosed

Accredited Body (legal name)

Preferred Contact Details

Address:

ABN

Please read this before answering the following question.

You must provide your name, read each statement carefully and then print your name, sign and date to provide your informed consent.

Applicant’s consent to submit a nationally coordinated criminal history check

I, acknowledge that I/the applicant have read and understand the statements below.

CLICK TO READ STATEMENTS *

Provide Full Name (including middle name) *

Signature: *

Clear

Date: *

THIRD PARTY/AUTHORISED AGENT SIGN - (person responsible for the applicant, such as a legal representative)

Authorised Agent (legal representative) must provide:

one of the documents listed as a 'Commencement of Identity Document' (such as Australian Passport)
one of the documents listed as a 'Primary Use in Community Document' (such as driver's license)
one of the documents listed as a 'Secondary Use in Community Document' (such as Medicare card)a documentary link between yourself and your Authorised Agent (such as court order)

Is an authorized agent acting on your behalf and signing the document? *

YesNo

Provide Full Name (including middle name) or Single Name: *

Date of Birth: *

Phone No: *

Select Commencement Document: *

Upload Commencement Document: *

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Select Primary Document: *

Upload Primary Document: *

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Select Secondary Document: *

Upload Secondary Document: *

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Upload proof of documentary link between yourself and Authorised Agent: *

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Signature: *

Clear

Date: *

PARENT/GUARDIAN CONSENT & SIGN - (where the applicant is under the age of 18)

Please have your parent or legal guardian provide each of the following documents:

one of the documents listed as a 'Commencement of Identity Document' (such as parent/guardian's Australian Passport)
one of the documents listed as a 'Primary Use in Community Document' (such as parent/guardian's driver's license)
one of the documents listed as a 'Secondary Use in Community Document' (such as parent/guardian's Medicare card)
a documentary link between yourself and your parent or legal guardian (such as your birth certificate or court order)

Are you the parent or legal guardian of the applicant? *

ParentLegal Guardian

Provide Full Name (including middle name) or Single Name: *

Select Commencement Document *

Upload Commencement Document: *

Browse

Select PRIMARY USE IN THE COMMUNITY document: *

Upload Primary Document: *

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Select SECONDARY USE IN THE COMMUNITY document: *

Upload Secondary Document: *

Browse

Upload proof of documentary link between yourself and your parent or legal guardian: *

Browse

Signature: *

Clear

Date: *

THREE DOCUMENTS ARE REQUIRED TO CONFIRM YOUR IDENTITY

+ PLUS A SELFIE PHOTO OF YOU HOLDING YOUR ID

1 COMMENCEMENT OF IDENTITY (to confirm your birth or arrival in Australia)

2 PRIMARY USE IN THE COMMUNITY (to show the use of your identity in the community)

3 SECONDARY USE IN THE COMMUNITY DOCUMENT

+ SELFIE PHOTO OF YOU HOLDING YOUR ID

IF YOU PROVIDE IDENTITY DOCUMENTS USING A FORMER NAME OR MAIDEN NAME THEN YOU MUST PROVIDE EVIDENCE OF THE NAME CHANGE IN ADDITION TO YOUR 3 X IDENTITY DOCUMENTS.

YOU WILL NEED ACCESS TO A SCANNER OR A MOBILE DEVICE WITH A CAMERA TO UPLOAD YOUR ID DOCUMENTS - PLEAE MAKE SURE THESE ARE NOT BLACK AND WHITE IMAGES

SELECT YOUR DOCUMENTS

1. Select START OF IDENTITY document: *

2. Select PRIMARY USE IN THE COMMUNITY document: *

Special Provisions - Select another PRIMARY USE IN THE COMMUNITY document:

3. Select SECONDARY USE IN THE COMMUNITY document: *

Special Provisions - Select another SECONDARY USE IN THE COMMUNITY document:

4. Select CHANGE OF NAME CERTIFICATE (if required) *

SPECIAL PROVISIONS APPLICATION PROCESS

Special provisions for applicants unable to meet the minimum proof of identity requirements

Since you’ve selected the special provisions process.

Elite Screening Australia obtain National Coordinated Criminal History Checks from the Australian Criminal Intelligence Commission (ACIC) who have very strict proof of identity requirements that must be met before any applications can be accepted.

If you are unable to provide the required ID from each category (eg x 1 Commencement, x 1 Primary and x 1 Secondary), it’s expected that you seek to obtain the missing/required documentation before proceeding with this order.

If you are unable to obtain and provide the required documentation, the ACIC can consider applications without the full ID requirements for exceptional circumstances only. For these situations, the ACIC need to understand why you’re unable to obtain the relevant documents with supporting evidence.

Unfortunately, the following are not valid reasons as to why you cannot obtain and provide the required ID from each category:

• I’ve lost it

• It’s expired

• I don’t currently have it with me

ACIC accepted reasons for not being able to obtain and provide the required ID include:

1. Foreign nationals living outside of Australia.

2. Persons whose birth was not registered

3. People who are currently homeless

4. Undocumented arrivals to Australia

5. People living in remote areas

6. People who are transgender or intersex

7. People affected by recent natural disasters

8. People with limited access to identity documents for reasons associated with how they were raised, such as in institutional or foster care

9. People with limited participation in society for example elderly, someone who has spent time in a rehabilitation centre10. Young people yet to establish a social footprint or evidence of community participation

Next Steps:

Option 1: Please seek to obtain the missing ID to meet the minimum requirements from each category. Once you have all the appropriate ID from each category, please come back to your Elite Screening Australia application and re-select your ID types from the list of options and upload the documents.

Option 2: If you are unable to obtain and provide the required ID from each category due to one of the accepted reasons above, please follow the instructions on the next page.

Option 3: If you are unable to progress with option 1 or 2, unfortunately Elite Screening Australia will not be able to progress with your order. In this scenario we recommend you:

a) For Individual Orders (you paid for this order) – request a refund at admin@elitescreeningaustralia.com.au

b) For Business Orders (an organisation paid for this order) – speak with this organisation for further advice.

SPECIAL PROVISIONS FORM

Have you attempted to obtain the missing document from the relevant organisation (eg, Birth Deaths & Marriages, Department of Immigration, Licencing Centre)? *

NO - Please seek to obtain the missing document before proceeding with this form.YES - Please provide a detailed explanation as to why the organisation cannot provide you the missing ID document:

Explanation:

Reason for not obtaining/providing required ID

Foreign Nationals Living Outside of Australia.

Provide the relevant supporting documents

Complete/obtain ALL the additional supporting documentation below as required by the ACIC
Click the button below to access a blank ‘Authorised Referee Report’
To complete the form later, click the ‘Save and complete later’ link at the bottom of this page. A return link will be emailed to you so you can resume once your documents are ready.
After completing the form and gathering all necessary supporting documents, please return to this page and click the button to upload them to your Elite Screening Australia application.

Supporting Documentation required by the ACIC (must provide all that are listed)

• Authorised referee report and
• Letter of engagement from the Australian company sponsoring the applicant and requesting the check (Not required if an Organisation ordered and paid for this check from the Elite Screening Australia platform)

AUTHORISED REFEREE FORM

Persons Whose Birth Was Not Registered

Provide the relevant supporting documents

Complete/obtain ALL the additional supporting documentation below as required by the ACIC
Click the button below to access a blank ‘Authorised Referee Report’ and Statutory Declaration Form.
To complete the form later, click the ‘Save and complete later’ link at the bottom of this page. A return link will be emailed to you so you can resume once your documents are ready.
After completing the form and gathering all necessary supporting documents, please return to this page and click the button to upload them to your Elite Screening Australia application.

Supporting Documentation required by the ACIC (must provide all that are listed)

• Statutory declaration - outlining your circumstance and reason for not having the required minimum identity documents and
• Authorised referee report

AUTHORISED REFEREE FORM

STATUTORY DECLARATION

People who are currently homeless

Provide the relevant supporting documents

Complete/obtain ALL the additional supporting documentation below as required by the ACIC
Click the button below to access a blank ‘Authorised Referee Report’ and Statutory Declaration Form.
To complete the form later, click the ‘Save and complete later’ link at the bottom of this page. A return link will be emailed to you so you can resume once your documents are ready.
After completing the form and gathering all necessary supporting documents, please return to this page and click the button to upload them to your Elite Screening Australia application.

Supporting Documentation required by the ACIC (must provide all that are listed)

• Statutory declaration - outlining your circumstance and reason for nothaving the required minimum identity documents and
• Authorised referee report

AUTHORISED REFEREE FORM

STATUTORY DECLARATION FORM

Undocumented arrivals to Australia

Provide the relevant supporting documents

Complete/obtain ALL the additional supporting documentation below as required by the ACIC
Click the button below to access a blank ‘Authorised Referee Report’ and Statutory Declaration Form.
To complete the form later, click the ‘Save and complete later’ link at the bottom of this page. A return link will be emailed to you so you can resume once your documents are ready.
After completing the form and gathering all necessary supporting documents, please return to this page and click the button to upload them to your Elite Screening Australia application.

Supporting Documentation required by the ACIC (must provide all that are listed)

• Statutory declaration - outlining your circumstance and reason for nothaving the required minimum identity documents and
• Authorised referee report

AUTHORISED REFEREE FORM

STATUTORY DECLARATION FORM

People currently living in remote areas

Provide the relevant supporting documents

Complete/obtain ALL the additional supporting documentation below as required by the ACIC
Click the button below to access a blank ‘Authorised Referee Report’.
To complete the form later, click the ‘Save and complete later’ link at the bottom of this page. A return link will be emailed to you so you can resume once your documents are ready.
After completing the form and gathering all necessary supporting documents, please return to this page and click the button to upload them to your Elite Screening Australia application.

Supporting Documentation required by the ACIC (must provide all that are listed)

• Authorised referee report Note – your address must also be classified as remote by the Accessibility/Remoteness Index of Australia (ARIA)

AUTHORISED REFEREE FORM

People who are transgender or intersex

Provide the relevant supporting documents

Complete/obtain ALL the additional supporting documentation below as required by the ACIC
Click the button below to access a blank ‘Authorised Referee Report’.
To complete the form later, click the ‘Save and complete later’ link at the bottom of this page. A return link will be emailed to you so you can resume once your documents are ready.
After completing the form and gathering all necessary supporting documents, please return to this page and click the button to upload them to your Elite Screening Australia application.

Supporting Documentation required by the ACIC (must provide all that are listed)

• Statement from a registered medical practitioner or a registered psychologist which specifies a change in gender; and
• Authorised referee report

AUTHORISED REFEREE FORM

People affected by recent natural disasters

Provide the relevant supporting documents

Complete/obtain ALL the additional supporting documentation below as required by the ACIC
Click the button below to access a blank ‘Authorised Referee Report’.
To complete the form later, click the ‘Save and complete later’ link at the bottom of this page. A return link will be emailed to you so you can resume once your documents are ready.
After completing the form and gathering all necessary supporting documents, please return to this page and click the button to upload them to your Elite Screening Australia application.

Supporting Documentation required by the ACIC (must provide all that are listed)

• Emergency services report or insurance documentation relating to theclaimed natural disaster; and
• Authorised referee report

AUTHORISED REFEREE FORM

People with limited access to identity documents for reasons associated with how they were raised, such as in institutional or foster care

Provide the relevant supporting documents

Complete/obtain ALL the additional supporting documentation below as required by the ACIC
Click the button below to access a blank ‘Authorised Referee Report’ and Statutory Declaration Form.
To complete the form later, click the ‘Save and complete later’ link at the bottom of this page. A return link will be emailed to you so you can resume once your documents are ready.
After completing the form and gathering all necessary supporting documents, please return to this page and click the button to upload them to your Elite Screening Australia application.

Supporting Documentation required by the ACIC (must provide all that are listed)

• Statutory declaration - outlining your circumstance and reason for not having the required minimum identity documents and
• Authorised referee report

AUTHORISED REFEREE FORM

STATUTORY DECLARATION FORM

People with limited participation in society for example elderly, someone who has spent time in a rehabilitation centre

Provide the relevant supporting documents

Complete/obtain ALL the additional supporting documentation below as required by the ACIC
Click the button below to access a blank ‘Authorised Referee Report’ and Statutory Declaration Form.
To complete the form later, click the ‘Save and complete later’ link at the bottom of this page. A return link will be emailed to you so you can resume once your documents are ready.
After completing the form and gathering all necessary supporting documents, please return to this page and click the button to upload them to your Elite Screening Australia application.

Supporting Documentation required by the ACIC (must provide all that are listed)

• Statutory declaration - outlining your circumstance and reason for not having the required minimum identity documents and
• Authorised referee report

AUTHORISED REFEREE FORM

STATUTORY DECLARATION FORM

Young people yet to establish a social footprint or evidence of community participation

Provide the relevant supporting documents

Complete/obtain ALL the additional supporting documentation below as required by the ACIC
Click the button below to access a blank ‘Authorised Referee Report’ and Statutory Declaration Form.
To complete the form later, click the ‘Save and complete later’ link at the bottom of this page. A return link will be emailed to you so you can resume once your documents are ready.
After completing the form and gathering all necessary supporting documents, please return to this page and click the button to upload them to your Elite Screening Australia application.

Supporting Documentation required by the ACIC (must provide all that are listed)

• Statutory declaration - outlining your circumstance and reason for not having the required minimum identity documents and
• Authorised referee report

AUTHORISED REFEREE FORM

STATUTORY DECLARATION FORM

Upload Document: 1/1

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full AUSTRALIAN BIRTH CERTIFICATE (not an extract, birth card or commemorative certificate)

First name on your Birth Certificate: *

Middle Name(s) (as it appears on your birth certificate):

Surname on your Birth Certificate: *

Date of birth on your Birth Certificate: *

Registration state or territory: *

Birth Registration Number: *

Birth Registration Date: *

UPLOAD BIRTH CERTIFICATE: *

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UPLOAD BIRTH CERTIFICATE: (back of certificate)

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CURRENT AUSTRALIAN PASSPORT - not expired, ((or no more than three years expired, if expired must be verified via the DVS).

CURRENT AUSTRALIAN PASSPORT - (not more than three years expired, if so, verified via the DVS,). This can only be used as a Primary use in the community document if it has not already been provided as a Commencement of Identity document.

Passport Number: *

First Name on your Passport: *

Middle Name(s) (required if you have one):

Surname on your Passport: *

Date of Birth on Passport: *

UPLOAD PASSPORT: *

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AUSTRALIAN VISA - (supported by a foreign passport, which is needed for verification) current at the time of entry into Australia as a resident or tourist. This can also be accessed through the Visa Entitlement Verification Online (VEVO) system delivered by the Department of Home Affairs; and

Full Name (as it appears on your Australian Visa): *

Date of Birth on your Australian VISA: *

Foreign Passport Number: *

Country of your passport *

UPLOAD AUSTRALIAN VISA & accompanying FOREIGN PASSPORT - 1/1 *

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UPLOAD AUSTRALIAN VISA & accompanying FOREIGN PASSPORT - 1/2

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ImmiCard - by the Department of Home Affairs to assist visa holders to provide evidence of their Commencement of Identity in Australia; and

ImmiCard number: *

ImmiCard Type:

First Name on your ImmiCard: *

Middle Name(s)

Surname on your ImmiCard: *

Date of Birth on your ImmiCard: *

UPLOAD IMMICARD: *

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UPLOAD IMMICARD:(back of card) optional

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official DFAT issued Identity Document

Which DFAT document do you have? *

DFAT Certificate of IdentityDFAT Document of Identity

DFAT document number: *

Full Name (as it appears on your DFAT document): *

UPLOAD DFAT CERTIFICATE / DOCUMENT OF IDENTITY: (front of document)) *

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UPLOAD DFAT CERTIFICATE / DOCUMENT OF IDENTITY (back of document) optional

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Certificate of Evidence (of resident status)

Full Name (as it appears on your Certificate of Evidence of Resident Status): *

Country Certificate Issued: *

Certificate of Evidence of Resident Status number: *

UPLOAD FRONT OF CERTIFICATE OF EVIDENCE (OF RESIDENT STATUS): 1/1 *

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UPLOAD BACK OF CERTIFICATE OF EVIDENCE (OF RESIDENT STATUS) - 1/2

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UPLOAD FRONT OF CERTIFICATE OF EVIDENCE (OF RESIDENT STATUS): 1/3

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UPLOAD FRONT OF CERTIFICATE OF EVIDENCE (OF RESIDENT STATUS): 1/4

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Australian Citizenship Certificate

Given Name(s) on your Australian Citizenship Certificate: *

Family Name on your Australian Citizenship Certificate: *

Certification/Issued date (DD/MM/YYYY) *

Australian Citizenship Certificate stock number: *

UPLOAD AUSTRALIAN CITIZENSHIP CERTIFICATE: (front page) *

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UPLOAD AUSTRALIAN CITIZENSHIP CERTIFICATE (back page) *

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current Australian Drivers Licence - learner permit or provisional licence issued by a state or territory, showing a signature and/or photo

First Name on your Drivers Licence: *

Middle Name(s)

Surname on your Drivers Licence: *

Drivers Licence issued in State/Territory: *

Drivers Licence Number: *

Driver Licence Card Number: *

UPLOAD FRONT OF DRIVERS LICENCE: *

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UPLOAD BACK OF DRIVERS LICENCE *

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Non-Australian Passport (current) issued by a country other than Australia with a valid entry stamp or visa

Non-Australian Passport number: *

Given Name(s) on your Non-Australian Passport: *

Family Name on your Non-Australian Passport: *

Country of Passport: *

Date of Birth on your Non-Australian Passport: *

UPLOAD CURRENT NON-AUSTRALIAN PASSPORT: *

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UPLOAD CURRENT NON-AUSTRALIAN PASSPORT - 1/2

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Current Proof of Age or Photo Identity Card (current) issued by an Australian Government agency in the name of the applicant, with a photo

Full Name (as it appears on your Proof of Age / Photo Identity Card): *

Card / Reference / CRN Number of your Proof of Age / Photo Identity Card:

Date of Birth on your Proof of Age / Photo Identity Card:

Expiry Date of your Proof of Age / Photo Identity Card: *

UPLOAD FRONT OF PROOF OF AGE / PHOTO IDENTITY CARD *

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UPLOAD BACK OF PROOF OF AGE / PHOTO IDENTITY CARD

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current Shooters / Firearms Licence

Firearms Licence No: *

Firearms Licence Date of Expiry: *

Full Name (as it appears on your Firearms Licence): *

Date of Birth on your Firearm Licence: *

State Issued:

UPLOAD FIREARMS LICENCE: (Front of Card) *

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Upload Firearms Licence (Back of Card) *

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For persons aged under 18 years with no other Primary Use in Community Documents, a student identity document

FULL Name (as it appears on your Student Identification document): *

Date of Birth on your Student Identification document:

Student Identification document No:

Student Identification Date of Expiry:

UPLOAD STUDENT IDENTIFICATION DOCUMENT: *

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UPLOAD STUDENT IDENTIFICATION DOCUMENT (back)

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official DFAT issued Travel / Identity document

Which DFAT issued document do you have? *

Australian Certificate of Identity (issued by DFAT)Australian Document of Identity (issued by DFAT)Convention travel document secondary (United Nations) issued by DFAT

First Name on your DFAT document: *

Middle Name(s) required if you have one:

Surname on your DFAT document: *

Date of Birth on your DFAT document: *

DFAT document number: *

Country Document Issued: *

UPLOAD DFAT ISSUED DOCUMENT: (front) *

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UPLOAD DFAT ISSUED DOCUMENT: (back) - optional

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current Foreign Government issued documents (eg: drivers licence)

Full name on your Foreign Government issued document: *

Date of Birth on your Foreign Government issued document: *

Foreign Goverment issued document number: *

Expiry Date: *

Country Issued: *

UPLOAD FOREIGN GOVERNMENT ISSUED DOCUMENT: *

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UPLOAD FOREIGN GOVERNMENT ISSUED DOCUMENT: (back)

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current Medicare Card

Full Name (as it appears on your Medicare Card): *

Medicare Card number: *

Individual Reference No: *

Medicare Card Expiry Date: (MM/YYYY) or (DD/MM/YYYY) *

Date of Birth *

UPLOAD MEDICARE CARD: *

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valid Enrolment with the Australian Electoral Commission (AEC)

FULL Name on your AEC enrolment: *

AEC Enrolment No:

AUSTRALIAN ELECTORAL ENROLMENT DETAILS UPLOAD: *

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current Security Guard or Crowd Control photo licence

Full Name (as it appears on your Security Licence): *

Security Providers Licence No: *

Security Licence Card Expiry Date: *

SECURITY GUARD OR CROWD CONTROL PHOTO LICENCE UPLOAD: (front of card) *

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SECURITY GUARD OR CROWD CONTROL PHOTO LICENCE UPLOAD: (back of card) *

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Centrelink Health Care Card or Pensioner Concession Card

Full Name (as it appears on your Australian Government Benefit document): *

Centrelink Card Type *

Date of Birth *

CRN / Number: *

Card Expiry Date *

EVIDENCE OF RIGHT TO AN AUSTRALIAN GOVERNMENT BENEFIT UPLOAD: (Front of card) *

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EVIDENCE OF RIGHT TO AUSTRALIAN GOVERNMENT BENEFIT UPLOAD - (back of card) *

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current Consular photo identity card (issued by DFAT)

Full name (as it appears on your Consular Photo Identity Card): *

Select Country Consular Photo Identity Card was Issued: *

Date of Expiry of Consular Photo Identity Card: *

CONSULAR PHOTO IDENTITY CARD UPLOAD: (front of card) *

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CONSULAR PHOTO IDENTITY CARD UPLOAD:(back of card)

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current Photo Identity Card (issued to an officer by a police force)

Full Name (as it appears on your Police Photo Identity Card:) *

Card Number (as it appears on your Police Photo Identity Card:) *

Date of Expiry (as it appears on your Police Photo Identity Card:) *

POLICE PHOTO IDENTITY CARD UPLOAD 1/1 (Front): *

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POLICE PHOTO IDENTITY CARD UPLOAD 1/2 (Back):

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current Photo identity card (issued by the Australian Defence Force)

Full Name (as it appears on your ADF Photo Identity Card): *

Card Number (as it appears on your ADF Photo Identity Card): *

Date of Expiry (as it appears on your ADF Photo Identity Card): *

ADF PHOTO IDENTITY CARD UPLOAD: (front of card) *

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ADF PHOTO IDENTITY CARD UPLOAD: (back of card)

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current Photo identity card (issued by an Australian government eg Working with Children/Occupational Licence)

Full Name on your Australian Government ID: *

Card No: *

Sate Card Issued *

Expiry Date: *

AUSTRALIAN GOVERNMENT PHOTO IDENTITY CARD UPLOAD: (front of card) *

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AUSTRALIAN GOVERNMENT PHOTO IDENTITY CARD UPLOAD: (back of card) *

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current Aviation Security Identification Card

Full Name on your Aviation Security ID: *

Card Number on your Aviation Security ID: *

Date of Expiry on your Aviation Security ID: *

AVIATION SECURITY IDENTIFICATION CARD UPLOAD: (front of card) *

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AVIATION SECURITY IDENTIFICATION CARD UPLOAD: (back of card) - optional)

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current Maritime Security Identification Card

Full Name on your Maritime Security ID: *

Card Number (as it appears on your Maritime Security ID): *

Date of Expiry on your Maritime Security ID: *

MARITIME SECURITY IDENTIFICATION CARD UPLOAD: (front of card) *

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MARITIME SECURITY IDENTIFICATION CARD UPLOAD: (back of card) - optional

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current and valid Credit Reference Check

Full Name on your Credit Reference Check: *

CREDIT REFERENCE CHECK UPLOAD: 1/1 *

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CREDIT REFERENCE CHECK UPLOAD: 1/2

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current Australian Tertiary or Secondary Student Photo Identity document

Full Name (as it appears on your Student Photo Identity document): *

Document / Card Number (as it appears on your Student Photo Identity document): *

Date of Expiry (as it appears on your Student Photo Identity document): *

AUSTRALIAN STUDENT IDENTITY DOCUMENT UPLOAD:(front of document) *

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AUSTRALIAN STUDENT IDENTITY DOCUMENT UPLOAD: (back of card)

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certified Academic Transcript from an Australian university

Full Name on your Academic Transcript: *

CERTIFIED ACADEMIC TRANSCRIPT UPLOAD: 1/1 *

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CERTIFIED ACADEMIC TRANSCRIPT UPLOAD: 1/2 - optional

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verifiable Trusted Referees Report

Full Name on your Trusted Referees Report: *

TRUSTED REFEREES REPORT UPLOAD: 1/1 *

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TRUSTED REFEREES REPORT UPLOAD: 1/2

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Bank Statement

FRONT OF YOUR BANK DOCUMENT: *

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recent Australian Taxation Office Assessment Notice

Full Name on your ATO Assessment Notice: *

Tax File No: *

AUSTRALIAN TAXATION OFFICE ASSESSMENT NOTICE UPLOAD: 1/1 *

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AUSTRALIAN TAXATION OFFICE ASSESSMENT NOTICE UPLOAD: 1/2

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Change of name

If you provide identity documents using a former name or maiden name, you must provide one of the below documents as evidence of the name change, in addition to your three identity documents

Change of name certificate issued by the Australian Registry of Births, Deaths and Marriages;

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Australian marriage certificate issued by a state or territory (church or celebrant certificates are not accepted);

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UPLOAD SELF PHOTO

'SELFIE' UPLOAD INSTRUCTIONS

Please take a photo of yourself HOLDING one of the ID's that you have UPLOADED

MAKE SURE YOUR PHOTO IS A CLEAR IMAGE AND YOUR ID CAN BE EASILY READ

Click below to take a photo or upload an image

UPLOAD PHOTO *

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Jobseeker/Applicant - Please VERIFY your EMAIL address...

Enter your email address: *

Re-enter & verify your email address *

Send code

ORDER DETAILS

Volunteer Police Check	$23.00
Credit Card Processing Fee	$0.69
Total (inc GST)	$23.69

Please enter your Credit Card details: *

Pay

Secure payments by Stripe. Visa/Mastercard/Amex accepted.

REVIEW & SUBMIT YOUR CHECK

ARE YOU SURE ABOUT THE DETAILS YOU ARE ABOUT TO SUBMIT?

IT NEVER HURTS TO DOUBLE CHECK...

YOU CAN CLICK BACK ON THE FORM TO RE-CHECK AND CORRECT DETAILS IF NEEDED.

REMEMBER THAT TO RECEIVE A RESULT, WE NEED THE RIGHT INFORMATION.

IF YOU ARE CERTAIN YOUR DETAILS ARE CORRECT

PROCEED TO SUBMIT

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