If you are dismissed from your job for a reason covered by general protections laws, you may be eligible to make a claim. You must apply within 21 days after the dismissal took effect.
On this page:
Before you start
Have this information ready before you begin this form. You will need to give us:
- your contact details
- details of a legal representative or paid agent*, if you have one
- the name of the employer's contact
- the legal name of the employer's business
- the trading name of the employer’s business
- the employer’s ABN, which you may find on your payslip or by searching the ABN Lookup website
- details of what the employer did, including any reasons given for your dismissal, that led you to make this application
- the section(s) of the Fair Work Act 2009 you believe your employer has broken (we give you the options to choose from)
- the outcome you want from this application
- details of any claim you have made to any other organisation about this dispute, if applicable.
Who can use this form
Only use this form if your employment has ended AND you think the reason is illegal ('prohibited') under general protections laws.
You cannot apply while you have another application in progress, such as unfair dismissal or dismissal under anti-discrimination laws.
How to pay the fee
The fee for 2021-22 is $74.90 and changes on 1 July each year. If you apply online, you can pay using a credit card. If you email or post your application, we will contact you about payment. We cannot process your application until you pay the fee.
You may not have to pay a fee if this would cause serious financial hardship. Apply for a waiver using Form F80
What happens next?
When we receive your application and payment, we will:
- send a copy to the employer (and any other respondents) and ask them to respond in 7 days AND
- organise a conference between you and the employer with a Commission conciliator.
Find out what happens in a conference.
Rules and regulations for this form
Fair Work Act 2009: Section 365
Fair Work Commission Rules 2013: Rule 45