Have read and understood the information provided in this application
form about how your personal information and any police information
relevant to you will be handled and disclosed
Provide your permission for the AuthNTick Identity Services to request
a nationally coordinated criminal history check on your behalf
Provide your permission for the AuthNTick Identity Services to
disclose your information to any organisation listed in "Authorisation
for disclosure of personal information" of this form
Acknowledge that I/the applicant understand the information on this
form.
Acknowledge that the accredited AuthNTick Identity Services is
collecting information in this form to provide to the Australian
Criminal Intelligence Commission (ACIC) and police agencies, for a
nationally coordinated criminal history check to be conducted for the
purpose outlined in Get Started Section of this form.
Have fully and accurately completed this form, and the personal
information I/the applicant, have provided relates to me/the
applicant, and contains the full name and all names previously used by
me/the applicant.
Acknowledge that withholding and/or providing misleading or false
information on this form and in any supplied identity documents is a
Commonwealth offence and may lead to prosecution under the Criminal
Code Act 1995 (Cth).
Acknowledge that personal information that I/the applicant provided in
this form and on the supplied identity documents may be disclosed to
the accredited body named in Section C of this form (including
contractors, legal entity customers, related bodies or third parties
named in Personal Detail of this form in Australia or overseas, if
applicable).
Acknowledge that any information sent by mail or electronically, in
relation to this form, including identity documents, is sent at my/the
applicant's risk and I/the applicant, am aware of the consequences of
sending information in these ways.
Acknowledge that I/the applicant am aware that I/the applicant am
providing consent for a national check to be conducted on all personal
information provided in this form and provided in suppled identity
documents.
Understand and consent to police information relating to me/the
applicant, being disclosed in accordance with the purpose identified
in section Get Started of this form, applicable legislation and
information release policies (including spent convictions legislation
described in Australian Government and state or territory
legislation).
Give consent to:
The ACIC and police agencies using and disclosing my/the
applicant's personal information that I/ the applicant, have
provided in this form and personal information contained in my
supplied identity documents to conduct a nationally coordinated
criminal history check.
The ACIC disclosing the police information sourced from the police
agencies to other approved bodies and the AuthNTick Identity
Services.
AuthNTick Identity Services the accredited disclosing to the legal
entity customer, third parties and any permitted offshore transfer
arrangements, my/the applicant's personal information and police
information to assess my/the applicant's suitability for the
purpose identified in section Get Started of this form.
Acknowledge that it is usual practice for my/the applicant's personal
information and police information to be used by police agencies and
the ACIC for law enforcement, including purposes set out in the
Australian Crime Commission Act 2002 (Cth).