Identification form – 100 point ID check
A form to provide proof of identity to support a WorkSafe licence application.
Important: Please download this PDF to your computer. You can fill it in using Adobe Reader as it may not save if you attempt to fill it in using your web browser.
About this form
You need to confirm your identity with the 100 point ID check form when applying for:
- blasting explosives licence
- driver transporting explosives licence
- high consequence dangerous goods (HCDG) permit
- pyrotechnician licence
You can also use this form if you can't complete the online identity check as part of your dangerous goods driver or engineered stone licence application. It can also be used for high risk work interstate transfers, but cannot be used for high risk work new, renewal or add a class applications.
Download the 100 point ID check form and provide the completed form, two passport size photographs and at least 3 identification documents to WorkSafe Victoria.
A reference check must also be completed if you have not provided one previously.
High risk work licence applicants
If you are applying for a high risk work licence do not use this form, you need to complete an identity check online (via the myworksafe portal) create an account or login.
Alternatively, you can submit your application for a licence to perform high risk work at an Australia Post outlet. If you are applying to renew an existing licence you will need to take your renewal notice with you, to obtain a new renewal notice please contact Worksafe Advisory on 1800 136 089.