Application for criminal history screening - prescribed notice (yellow card) (Form 10-1)


For use by a Department of Communities, Disability Services and Seniors funded non-government service provider or a National Disability Insurance Scheme (NDIS) non-government service provider on behalf of a person engaged or seeking to be engaged by the service provider.


  1. Check that your details are correct
  2. Ensure that the applicant has completed 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. If you are a sole trader, your identification documentation must be witnessed by a justice of the peace.

Submitting your request

Further information

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