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How to Complete the Consent Form for a Police History Record Check

When filling out the application form please make sure the following information is included.

SECTION 1: APPLICANT DETAILS
 - In this section the following must be completed.

• Family name and all other surnames you have been known by.
• Given name and any other given names you have been known by.
• Current residential address. 
• Date of birth and place of birth (e.g. Hobart, Launceston).
• Day-time telephone number.  This number will be used should we need to contact you regarding your application.
• Previous addresses and driver licence details are encouraged as they help with identification if there is a person with similar details.

SECTION 2: TYPE OF POLICE HISTORY RECORD CHECK REQUIRED
- In this section you must tick which type of Police History Record Check you require. 

• National Police History Record Check
  Current fee $45.00.
   - A check will be made of the police records held by all Australian police jurisdictions.
• National Police History Record and Fingerprint Check
  Current fee $120.00.
   - A check will be made of the police and fingerprint records held by all Australian police jurisdictions.
• Tasmania Police History Record Check
  Each Person is entitled to a free Tasmania Police History Record Check every 12 months.
   - A Check will only be made of those records held by Tasmania Police.
   - Note: People requiring a restricted driver’s licence need a Tasmania Police History Record Check.

SECTION 3: LEVEL OF INFORMATION REQUIRED
- In section 3 you must tick one box only.

A: Annulled Record
Used primarily for most employment opportunities or third party purposes.

• Minor convictions (findings of guilt) that have met the required period of good behaviour will be annulled from the record, in accordance with the Annulled Convictions Act 2003. These annulled convictions will not appear on the record provided.

B: Full Record
Provided in accordance with the Record of Offences (Access) Act 1981.

• Details of all offences will be released including all court outcomes and details of youth justice offences.
• Details of all informal or diversionary cautions will be released.

Note: Due to the level of information being released, this record is for personal use only and will only be sent to your nominated residential or postal address.

C: Schedule 1 – Annulled Convictions Act 2003
In accordance with the Annulled Convictions Act 2003, persons applying for positions or licences as detailed in the Schedule must request this level of check.  These include employment positions involving contact with children, security agents, law enforcement or public vehicle licences.

• No convictions (for findings of guilt) can be annulled from the record, in accordance with the legislation.  All convictions must remain on the record including those under the Youth Justice Act 1997.
• Details of any informal or diversionary cautions will not be released.

SECTION 4: STATEMENT OF CONSENT AND INDEMNITY
- In this section the following must be completed.

• Write your name and address or the name and address of the person or organisation where you require the information to be sent.
• Please sign the form and also have a witness sign it.  The witness may be anyone who knows you, i.e. husband, wife, mother, father or friend.

SECTION 5: INSTRUCTIONS FOR COMPLETING THIS FORM
- Please read section 5 carefully.  You must:

• Attach a copy of three different forms of identification. Check the application form for a list of accepted documents.
• If you are required to pay a fee, please attach a cheque or money order to your application form.
• Alternatively you may pay with credit card by filling out your details in the area provided on the application form.  

Note: If you are required to pay a fee, no results will be released until payment is received.

SECTION 7: DECLARATION OF VOLUNTEER STATUS
Volunteers seeking employment with organisations with prior authorisation from Tasmania Police may be eligible to receive a National Police History Record Check at a reduced fee.

• If your organisation is registered with Tasmania Police please have section 7 signed by an authorised officer.

Volunteer rate application form

Application for a Police History Record Check