Notification of health and safety representatives

Section 74 of the Work Health Safety (National Uniform Legislation) Act 2011 requires a person conducting a business or undertaking (PCBU) to display, make readily available and provide the Regulator with a list of Health and Safety Representatives (HSR) and Deputy HSR in their workplace.

This form can be used to assist in meeting your obligations under Section 74. It is not mandatory to use this form and the information required by Section 74 can be provided in a different format.