Government of Western Australia
WorkSafe
Compliance with Improvement Notice
The person to whom an improvement notice is issued must, as soon as is reasonably practicable after complying with the notice, notify the regulator of that compliance. Failure to notify the regulator of compliance, as soon as is reasonably practicable after compliance with the notice, may constitute an offence which may attract a penalty of $55,000 for an individual or $285,000 for a body corporate.
Please complete the compliance details below.
Notice number
This is the unique eight-digit number stated on the improvement notice.
Date of issue
This is the date on which the improvement notice was issued, stated on the improvement notice.
e.g. dd/mm/yyyy
Inspector name
This is the name of the WorkSafe inspector who issued the improvement notice, stated on the improvement notice.
I certify that the requirements of this notice have been completed.
Name
Position
Date
e.g. dd/mm/yyyy
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