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APPROVED PROVIDERS under the AGED CARE ACT 1997 NOTIFICATION OF CHANGES TO KEY PERSONNEL FORM This form is to be used to notify the Department of Social Services of adding a Key Personnel. Send the
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How to Fill Out Disqualified Individual Notification Form:

01
Begin by reading the instructions: Before you start filling out the disqualified individual notification form, it is essential to carefully read and understand the provided instructions. This will ensure that you provide accurate and complete information.
02
Provide personal details: Start by entering your personal details, such as your full name, address, date of birth, and contact information. Ensure that all information is accurate to avoid any discrepancies.
03
Identify the reason for disqualification: Determine the specific reason for the disqualification that requires filling out this form. This might include a criminal record, professional misconduct, or any other disqualifying factors. Clearly state the reason for disqualification in the designated section.
04
Include supporting documentation: Attach any supporting documents required to provide evidence or support your claim of disqualification. This might include court records, disciplinary actions, or any relevant documentation that showcases the disqualifying factor.
05
Provide additional information: If there is any additional information that is relevant to your disqualification, make sure to include it in the provided section. This could be details about previous employment, licenses, or certifications that are affected by the disqualification.
06
Sign and date the form: Once you have completed all the necessary sections, sign and date the form to authenticate the information provided. Failure to sign the form may result in it being deemed incomplete.

Who Needs Disqualified Individual Notification Form:

01
Individuals with disqualification concerns: The disqualified individual notification form is required for individuals who have been disqualified or are facing potential disqualification. Whether it is due to a criminal record, ethical misconduct, or other disqualifying factors, individuals who fall into this category will need to fill out this form.
02
Organizations or authorities: The disqualified individual notification form is typically required by organizations or authorities responsible for screening and monitoring individuals' qualifications. This can include government agencies, licensing boards, or other regulatory bodies that need to be made aware of an individual's disqualification.
03
Employers or educational institutions: In certain cases, employers or educational institutions may also request the disqualified individual notification form from applicants or employees. This could be part of their due diligence process to ensure that individuals meet the necessary qualifications and standards for employment or enrollment.
Remember, it is essential to follow any specific instructions or regulations provided by the relevant organization or authority when completing the disqualified individual notification form.
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