Vetting Service
Request & Consent Form
General Information for an Australian National Police History Check, (continued)
The following links may be helpful in sourcing information on Spent Convictions in the Australian States & Territories but may
not be relied upon. If further information or clarification is required please contact the individual Australian Police Agencies
directly for further information about their release policies and any legislation that affects them.
www.comlaw.gov.au
New South Wales
www.legislation.nsw.gov.au
Queensland
www.legislation.qld.gov.au
www.legislation.sa.gov.au
Victoria Police
www.police.vic.gov.au
Tasmania
www.slp.wa.gov.au
Northern Territory -
www.nt.gov.au/dcm/legislation/current.html
Australian Capital Territory
www.legislation.act.gov.au
Provision of incomplete, false or misleading information
An Approved Agency or Applicant must take reasonable steps to ensure that the personal information collected, or disclosed
is accurate, complete and up to date.
You are asked to certify that the personal information you have provided on this form is correct. If it is subsequently discovered,
for example as a result of a check of police records, that you have provided incomplete, false or misleading information, you
may be assessed as unsuitable.
It is a serious offence to provide false or misleading information in Australia.
(for Australian National Police History Check)
1. I have read the General Information in section 3 of this form and understand that information will be disclosed in accordance
with applicable legislation and information release policies (including spent convictions legislation, however described) in
the Commonwealth, States and Territories;
2. I understand that the position/entitlement for which I am being considered may be in a category for which exclusions from
Spent Convictions legislation may apply;
3. I have fully completed this form, and the personal information I have provided in it relates to me, contains my full name and
all names previously used by me, and is correct;
4. I acknowledge that the provision of false or misleading information is a serious offence;
5. I acknowledge that the Approved Agency named in Section 1 of this form is collecting information in this Form to provide
to New Zealand Police to provide to ACIC (an Agency of the Commonwealth of Australia) and the Australian Police Agencies;
6.
:
a. ACIC using and disclosing personal information about me in this form to the Australian Police Agencies;
b. the Australian Police Agencies disclosing to ACIC, from their records, Police History information that can be disclosed in
accordance with the laws of the Commonwealth, States and Territories and in accordance with the relevant
jurisdiction’s information release policies;
c. ACIC disclosing the information disclosed by the Australian Police Agencies to New Zealand Police, and
d. New Zealand Police disclosing any criminal history information about me to the Approved Agency named in Section 1
of this form to assess my suitability in relation to my application;
7. I acknowledge that any information provided by me in this form relates specifically to the purpose identified in Section 1 of
this form;
8. I acknowledge that any information provided by the Australian Police Agencies or ACIC relates specifically to the purpose
identified in Section 1 above;
9. I acknowledge that personal information that I provide in this form may be disclosed to the Approved Agency named in
Section 1 of this form (including contractors or related bodies corporate) located in New Zealand or overseas; and
10. I acknowledge that it is usual practice for an Applicant's personal information in this form to be disclosed to New Zealand
Police and Australian Police Agencies for them to use for their respective law enforcement purposes including the
investigation of any outstanding criminal offences.
Note: The information provided in this form will be used only for the purpose stated above unless statutory obligations require
otherwise.
Applicant’s Authorisation:
I have read and understood the information above and consent accordingly
. Signed in electronic form
or, Signature: ____________________________ Date:
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