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Request for Conciliation Office use Ref/ Act Section Please read the back of this form before completing this page. Further information is available at our website: www.conciliation.vic.gov.au Worker
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How to fill out request for conciliation form

How to fill out a request for conciliation form:
01
Obtain the form: Begin by acquiring a copy of the request for conciliation form from the relevant agency or organization. This can usually be done by visiting their website or contacting their office.
02
Fill in personal information: Start by providing your personal details such as your full name, address, contact number, and email address. Make sure to double-check the accuracy of this information to avoid any potential communication issues.
03
Clearly state the purpose: Indicate the purpose of the request by writing a concise and specific statement. Explain why you are seeking conciliation and the issue or dispute that needs to be addressed. Be clear and objective in your explanation.
04
Provide relevant details: Include any relevant information that supports your request. This may include dates, times, places, individuals involved, and any other pertinent facts. Provide as much detail as possible to help the conciliation officer or mediator understand the context of the dispute.
05
Attach supporting documents: Attach any supporting documentation that may strengthen your case or provide evidence of the issue at hand. This can include contracts, agreements, invoices, emails, letters, or any other relevant paperwork. Ensure that all attachments are organized and labeled correctly.
06
Sign and date the form: Review the completed form to ensure all sections are filled out accurately and completely. Once satisfied, sign and date the form in the designated area. This signifies that the information provided is true and accurate to the best of your knowledge.
Who needs a request for conciliation form?
A request for conciliation form is typically needed by individuals or organizations who are involved in a dispute and wish to seek a resolution through the process of conciliation. This could include employees and employers in workplace conflicts, tenants and landlords in rental disputes, consumers and businesses in consumer complaints, or individuals involved in any other legal or civil disagreement. The form serves as a formal request to initiate conciliation proceedings and should be completed by the party seeking resolution.
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