Application for cancellation of negative notice or negative exemption notice (Form 10-5)

Purpose

For use by a person seeking to have a negative notice or negative exemption notice cancelled.

• Application for cancellation of negative notice or negative exemption notice (PDF, 1.3 MB) Application for cancellation of negative notice or negative exemption notice (DOC, 142 KB)

Checklist

1. Check that your details are correct
2. Complete the declaration
3. Complete the payment details section (Part F)
4. If payment is by credit card, please pay online via:
   Make a Yellow Card Application payment
5. Ensure all signatures are on the form
6. Have your identification documents certified by a Justice of the Peace

Submitting your request

• Mail: Department of Communities, Disability Services and Seniors
  PO Box 10179, Adelaide Street Brisbane QLD 4000
• Email: criminalhistoryscreening@disability.qld.gov.au

Further information

If you have any questions please email Criminal History Screening or phone the criminal history screening hotline: 1800 183 690.