A member of a union’s committee of management applies for a Work Health and Safety permit on behalf of the permit holder. Do not send Form F42A without a statutory declaration (Form F42B).
On this page:
Who can use this form
The committee of management member submits the application.
Before you start
To fill out the form, the committee of management member needs:
- the legal name of the permit holder
- the job title of the permit holder
- the address of the union or branch where we should send the permit if it is issued
- details of the Fair Work entry permit the permit holder has, or the union has applied for
- details of any previous WHS permit for the permit holder.
The committee of management member needs to submit Form F42B - statutory declaration with the application.
We store your information in line with the Form F42A privacy notice (pdf).
Apply now
To apply, email your documents to [email protected].
You can also send or deliver your documents to the Commission office near you.
What happens next?
We recommend you apply 4 weeks before you need the permit. After we receive the application, we will contact you if we need more information.
Rules and regulations for this form
Work Health and Safety Act 2011: Section 131