Compliance Slip for Improvement Notice

This compliance slip is to be returned when requirements in the improvement notice have been completed (the notice has been complied with).

Section 48(5) of the Act provides that a person to whom an improvement notice is issued commits an offence if the WorkSafe Western Australia Commissioner is not notified forthwith upon the requirements of the improvement notice being satisfied.
This is the unique eight digit number that is stated at the bottom-right of the improvement notice form.
This is the date on which the improvement notice was issued. It is stated on the improvement notice form next to the address.
This is the name of the WorkSafe Inspector who issued the improvement notice. It is stated at the bottom right of the improvement notice form.
I certify that the requirements of this notice have been completed.
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