Notice from an Interstate Licensee of Intention to Work in the ACT

About this form

This form is to be used to notify WorkSafe ACT under Sections 488 and 490 of the Work Health and Safety Regulation 2011 of an interstate licensed asbestos licence holder's intention to work in the ACT.


There is no fee for this notification.

Lodging your Notification

This notification must be provided to WorkSafe ACT at least 5 days before the work commences. This notification is submitted once prior to commencement of work in the ACT.


Construction and Workplace Licensing
Phone: 02 6207 8096

Your personal information

The personal information on this form is provided to Access Canberra of the ACT Government to enable the processing of your application. If all or some of the personal information is not collected, Access Canberra cannot process your application.

The personal information you provide may be disclosed to the other ACT Government Directorates, and third parties external to the ACT Government, as required by specific legislation administered by Access Canberra.

The Information Privacy Policy Annex contains information in regard to what information Access Canberra collects and to whom it is disclosed. The policy also contains information about how you may access or seek to correct your personal information held by Access Canberra, and how you may complain about an alleged breach of the Territory Privacy Principles. The Information Privacy Policy can be found on the CMTEDD website, under the "Privacy" menu.