Acknowledgement and consents

By submitting this form:

• You acknowledge that you have read the General Information above 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);
• You understand that the purpose for which you are seeking a NCCHC may be in a category for which exclusions from spent convictions legislation may apply;
• You have fully and correctly completed this form, the personal information you have provided in it relates to you, contains your full name and all names previously used by you;
• You acknowledge that the provision of false or misleading information on this form is a serious offence;
• You acknowledge that Crime Check Australia is collecting information in this form to provide to Australian Criminal Intelligence Commission (ACIC) (an Agency of the Commonwealth of Australia) and police agencies;
• You acknowledge that any police information relating to you is being disclosed in accordance with the purposes stated in this form;
• You acknowledge that any information provided by the police agencies or ACIC relates specifically to the purpose identified in this form;
• You acknowledge that any information sent, by mail or electronically, in relation to this form, including any identity documents, is sent at your own risk and you are aware of the consequences of these methods of lodgment;
• You acknowledge that personal information and police information that you provide in this form may be disclosed to Crime Check Australia and third-party organisations in jurisdictions outside Australia listed in the section titled ‘Disclosure of your personal and police information’ above ; and
• You acknowledge and consent to your personal information being disclosed to police agencies and used for general law enforcement purposes including the investigation of any outstanding criminal offences, including those purposes set out in the Australian Crime Commission Act 2002 (Cth).

You consent to:

• a Nationally Coordinated Criminal History Check being undertaken on all names under which the applicant was, is or has been known, as provided by you to Crime Check Australia;
• ACIC and police agencies using and disclosing your personal information to conduct a Nationally Coordinated Criminal History Check;
• the police agencies disclosing to ACIC, from their records, Criminal History 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;
• ACIC disclosing the information sourced from the police agencies to Crime Check Australia;
• Crime Check Australia, where applicable, disclosing to the employer/organisation personal information to assess your suitability in relation to the purpose identified in this form.
• Crime Check Australia, where necessary, searching, retrieving and storing Visa Entitlement Verifications Online – commonly known as VEVO Checks- as well all of the information contained within those checks, with the aim of verifying your identity;
• Where applicable, Crime Check Australia disclosing the results of your Nationally Coordinated Criminal History Check to your employer or prospective employer.

Note: The information you provide on this form will be used only for the purpose stated in this form unless statutory obligations require otherwise.