I declare that, to the best of my knowledge, the information provided in this application and supporting this application is true and correct.
I declare that where I provide information to WorkSafe about another individual, I am authorised to provide that information, the information has been collected in accordance with the Privacy and Data Protection Act 2014 and that individual has been or will be made aware of the matter of which an individual is required to be made aware when personal information is collected about them.
Collection of personal information
Personal and/or health information collected by WorkSafe Victoria (WorkSafe) in connection with this application will be used for the purpose of assessing this application, any associated applications, and administering the licence/registration.
The information collected may also be used in the administration and enforcement of legislation administered by WorkSafe, including the Occupational Health and Safety Act 2004 and the Dangerous Goods Act 1985, the administration and evaluation of WorkSafe’s programs generally, and for law enforcement functions and legal proceedings.
WorkSafe may disclose personal and/or health information for public health and safety purposes. It may disclose that information to other government agencies, including emergency services, law enforcement, and security agencies, including Victoria Police. WorkSafe may also disclose personal and/or health information to its contractors and agents, to a court or tribunal, to other regulatory agencies, and to any person authorised to whom it relates, or by law, to obtain it.
WorkSafe may disclose a person’s licence status to employers, prospective employers, or members of the public who wish to check this status.
Collection of your personal and/or health information may be required by the Occupational Health and Safety Act 2004 or Dangerous Goods Act 1985 and associated regulations. If you do not provide any or all of the information, your application may not be accepted or processed. You may access your personal information held by WorkSafe by contacting the Freedom of Information and Privacy Team.
WorkSafe’s Privacy Policy is available at www.worksafe.vic.gov.au.
I agree to the above declaration and consent to the collection of personal information by WorkSafe.