Police National Form – Fill Out and Use This PDF

INSTRUCTIONS FOR APPLICANTS

Applications for a National Police Certificate may be made online at www.police.nsw.gov.au. This

form is for use by applicants without internet access.

Applicants must ensure form is completed in full and purpose of the check is clearly stated. Incomplete forms will cause delays.

1.Complete sections A, B and C in black or blue ink using BLOCK LETTERS. Place one character per space leaving a space between each word.

2.Contact the NSW Police station nearest your place of residence to organise a time and location to submit the application form. Applicants must notify police prior to attending the station if fingerprints are required for visa or adoption purposes. (Individuals applying via Registered Organisations should submit forms directly to authorised Registered Organisation personnel).

3.Present application form and three (3) types of acceptable identification to the nominated police station at the allocated time.

4.Pay the appropriate fee. Fees are:

·Name and date of birth check ($54.60) or

·Name and date of birth check for volunteers working in commonwealth supported aged-care check ($15) or

·Name, date of birth and fingerprint check ($183.70).

·Fee for Retired Officers Identification Card – Waived (Police Officers Only)

5.Applicants with more than three (3) previous/alias names must complete Form P826 - Additional information for NPCS purposes and present to NSW Police Force or Registered Organisation personnel when submitting application.

The NSW Police Force does not provide Working With Children Checks. Individuals seeking a Working With Children Check Clearance should refer to the Office of the Children’s Guardian website www.check.kids.nsw.gov.au.

However, some employers of persons in child-related work may also require a National Police Check to assess the suitability of a person for employment in a particular position. Some workers may therefore separately apply to the Office of the Children’s Guardian for a Working With Children Check and to the NSW Police Force for a National Police Check.

COMPLETING APPLICATION FORM:

Section A: Applicant details

Provide the following details in the spaces provided:

·Full name (including middle name), date of birth and gender.

·Country of Birth (if the Country of Birth is Australia then the Town/City and State must also be provided).

·All previous names or aliases by which you are, or have formerly been known, including maiden name.

·Details of your current and previous residential address.

·Details of identification types that confirm your identity.

Applicants must list three (3) types of acceptable identification from the list below. Identification must be current and should include at least one type of photographic ID and identification that contains a signature and date of birth. Applicants must record in the space provided the identification type and number (if applicable). Acceptable types of identification are:

Passport	Drivers Licence	Certificate of Marriage or Change of Name	Govt issued identity card
Birth Certificate	Citizenship Certificate	Medicare / Private health care card	Credit card
Student identity card	Union/Professional membership card	Senior Citizen / Govt concession card	Rates notice
Govt issued license	Photographic employee identity card	Utility account (eg electricity, gas, telephone)	Govt. issued proof of age card

Section B: Purpose of check

Applicants must:

·Select the Name and date of birth check box for employment or licensing purposes or student placement OR

·Select the Name and date of birth check - volunteer - Commonwealth funded care services check box (these checks will have ‘aged care volunteer use only’ printed on the certificate, therefore, the certificate is not suitable for any other purpose.

·Select the Name, date of birth and fingerprint check box if required for visa or adoption purposes AND the overseas country or the adoption organisation which has requested a fingerprint check.

·Indicate whether the check is for employment, licensing, visa or adoption purposes.

·Provide specific details of the purpose of the check. For example checks for employment purposes must include the type of occupation (eg cleaner, electrician); licensing checks must nominate the type of licence (eg boat licence); visa applications must include the country for which the visa is required (eg Canada).

Section C: Acknowledgement and Consent

By completing the Acknowledgement and Consent section, the applicant agrees to the following:

“I hereby acknowledge, consent and do request NSW Police Force and other Australian police agencies to release, to the person or organisation specified herein, information held by any of them regarding any convictions, findings of guilt, either with or without conviction, and any matters still outstanding against me and any other matters deemed relevant which are recorded, or may in the future come to be recorded, against me or one of my associates or relatives at the time of filing this application and for the duration of any contract with NSW Police Force (hereinafter referred to as ‘Such Information’). I acknowledge that any information obtained as part of the national criminal history record check and for the duration of any contract with NSW Police Force, may be used by Australian police agencies for law enforcement purposes; including the investigation of any outstanding criminal offences, and for consideration of the continuation of any contract with NSW Police Force resulting from this application”.

“I acknowledge and agree:

(a)that the NSW Police Force relies on other State and Commonwealth jurisdictions (Other Agencies) to provide information to it (Other Agency Information) in order to produce a National Police Certificate.

(b)to release the NSW Police Force from any liability arising from any errors or omissions contained in that Other Agency Information; and

(c)to indemnify the NSW Police Force for any loss suffered or expense incurred by it arising out of errors or omissions contained in that Other Agency Information.

The above acknowledgement does not alter any rights I may have under legislation”.

Applications will not be processed if consent section is incomplete. Applicants must provide the name and address of the individual or organisation to which the National Police Certificate is to be released. No copies of the National Police Certificate will be issued.

Please Note:

NSW Police Force relies on other State and Commonwealth jurisdictions to provide information in order to produce a National Police Certificate.

NSW Police Force will not be held liable for any loss, suffered or expense incurred by an applicant arising out of errors or omissions contained in information obtained from other agencies.

If an applicant incurs a loss or monetary expense arising out of errors or omissions contained in information obtained from other agencies, they may be able to make an application for an ex gratia payment.

For further information on ex gratia applications please follow the following link. http://www.lsb.lawlink.nsw.gov.au/lsb/legal_services_appl_costs/legal_services_exgratia_pay.html

Section D: Official use only

Items 1-7 to be completed by NSW Police Force or authorised Registered Organisation personnel ONLY.

1.Ensure the applicant has completed the application in full.

2.Confirm the identity of the applicant by sighting three (3) acceptable types of identification and tick the ID confirmed box.

3.Record the date application was received.

4.Record the police station cost centre number or Registered Organisation customer number.

5.Select appropriate fee category. (Police must select Individual category, Registered Organisations must select Commercial).

6.Record the name of the Police Station (or Registered Organisation) at which the application was processed.

7.Record the employee number of police or Registered Organisation personnel processing application.

Items 8-9 must also be completed by NSW Police Force personnel when processed via a police station

8.Record the fee collected from the applicant.

9.Record the general/miscellaneous receipt number issued to the applicant.