When you apply to hold a Work Health and Safety entry permit, you must complete a statutory declaration using Form F42B. Submit it with the application (Form F42A).
Who can use this form
Only use this form if you are an official of the union.
You must fill out this form in front of an authorised witness who also signs the form. See the Attorney General’s website for:
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 proposed permit holder needs to submit Form F42B - statutory declaration with the application.
We store your information in line with the Form F42B privacy notice (pdf).
Lodge now
Lodge this document with the permit application (Form F42A) and evidence you have completed the required training under the Work Health and Safety Act 2011.
To lodge, email your documents to regorgs@fwc.gov.au. You can also send or deliver your documents to the Commission office near you.
Rules and regulations for this form
Work Health and Safety Act 2011: Section 131