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:
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.
Before you start
An application is the start of a legal process. When you lodge this form you will need to pay a fee.
We can only extend the deadline for lodging an application in exceptional circumstances. For information on how the 21 days is calculated, go to Timeframe for lodgment.
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.
Answer every question in the form and tell us briefly what happened. If you need help, look at the sample application form. If you do not understand a question you can Contact us.
Submit your form by no later than 11:59 pm on the 21st day after your dismissal took effect.
Lodge your form online. To get started click on Apply online, follow the prompts to log in or set up an account. Alternatively email your completed form to firstname.lastname@example.org.
You can also post or deliver your form to the Commission office near you. In some circumstances you can make an application over the phone.
The application fee
You need to pay a fee when you apply. The fee for 2022-23 is $77.80 and changes on 1 July each year.
If you apply:
- online - you can either pay the lodgment fee or request to have it waived when you submit your online application
- by email or post - 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?
After we receive your application and payment, we will:
- send a copy to your employer (and any other respondents) and ask them to respond in 7 days AND
- organise a conference between you and the employer to help you and your employer discuss the issues.
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