Last updated – November 2019 Page 3 of 3
Skills Assessment
Review Application Form
5. Applicant declaration and consent
Please tick each clause below and sign the declaration
I, (the applicant) declare that:
I understand that providing false or misleading information is an offence and all the information I
have provided is true and correct.
I have read and understood ACECQA’s application guidelines and assessment standards.
I authorise ACECQA to make enquiries to third parties in order to verify any additional evidence or
information I have supplied in my request for a review of my skills assessment outcome.
I understand that a review is not a guaranteed process and can be reasonably refused by ACECQA.
I understand that if my request for review is approved, the review of my skills assessment outcome
will take up to 28 calendar days from the date I provide all the information required by ACECQA.
I understand that if I receive an unsuccessful review outcome I will not be entitled to a refund.
If I have provided anyone else’s personal information, I confirm that it is with their consent.
I will inform ACECQA of any changes to my circumstances (e.g. change of contact details) while my
application is being processed.
I have read and understood ACECQA’s privacy policy.
Day Month Year
Signature of Date
applicant
Day Month Year
Signature of Date
authorised
witness
Authorised witness name
(Printed)
Authorised witness occupation
or JP number
Please note: The witness must be a person authorised to certify documents in Australia e.g. a Justice of the Peace.
