Form F10 – Application for the Fair Work Commission to deal with a dispute in accordance with a dispute settlement procedure Instructions

Enter the phone number of the applicant.

Enter the postal address of the applicant.

Enter the suburb for the applicant's postal address.

Enter the email address of the applicant.

Enter the postcode for the applicant's postal address.

Enter the state or territory for the applicant's postal address.

Enter the applicant's age in years if they are 18 years or older (provide the whole number of years). Fill only if '18 years or over (adult)' is 'Yes'.

Enter the applicant's age in years if they are under 18 (provide the whole number of years). Fill only if 'Under 18 years' is 'Yes'.

Check this box if the applicant is 18 years old or older (an adult).

Check this box if the applicant is younger than 18 years of age.

Enter the name of the collective agreement.

Please provide your email address.

Please enter the state or territory of the address.

Please provide your contact phone number.

Please enter the suburb of the address.

Please enter your full postal address, including street number and name.

Please enter the postcode of the address.

Provide a detailed description of the dispute using numbered paragraphs, including references to any relevant clauses.

Check this box if the application relates to a dispute about the exercise of an employee's right to disconnect.

Check this box if the application does not relate to a dispute about the exercise of an employee's right to disconnect.

Check this box if the application relates to a dispute about the exercise of entitlements of an employee in their capacity as a workplace delegate.

Check this box if the application does not relate to a dispute about the exercise of entitlements of an employee in their capacity as a workplace delegate.

Provide the industry in which the employer operates.

Check this box if the application relates to a dispute about changing from casual employment to full-time or part-time employment.

Check this box if the application does not relate to a dispute about changing from casual employment to full-time or part-time employment.

Provide the eight-digit ID code of the enterprise agreement, which starts with 'AE'.

Provide the name of the enterprise agreement.

Check this box if the application relates to an employer's refusal of a request for flexible working arrangements.

Check this box if the application does not relate to an employer's refusal of a request for flexible working arrangements.

Enter the current page number of the form.

Enter the current page number of the form.

Enter the applicant's family name or last name.

Enter the applicant's primary email address for contact.

Enter the applicant's preferred telephone number, including country and area code if applicable.

Enter the applicant's full postal address (street number, street name and any unit or PO box).

Enter the applicant's given first name(s) as they normally use them.

Enter the suburb or locality of the applicant's postal address.

Enter the postcode for the applicant's postal address.

Enter the applicant's state or territory for their postal address.

List the clause(s) within the relevant industrial instrument or other written agreement that the dispute relates to, including any relevant National Employment Standard.

Provide the clause number from the relevant industrial instrument or written agreement that contains the dispute settlement procedure.

Provide the name of the instrument or other written agreement that contains the dispute resolution procedure.

Enter the ID code of the instrument or other written agreement, if applicable.

Please specify the language for which an interpreter is required.

Check this box if you require an interpreter and need to specify the language.

Check this box if you do not require an interpreter.

Check this box when you are lodging the completed form together with any supporting documents with the Commission.

Check this box when you are lodging a copy of the dispute settlement procedure that requires or allows the Commission to deal with a dispute.

Enter the name of the minimum standards order.

Enter the name of the modern award.

Enter the full name of the primary contact person for the non-individual applicant (for example a company representative).

Enter the applicant’s Australian Company Number (ACN) if the applicant is a company.

Enter the full legal name of the non-individual applicant (eg company, organisation or other entity).

Enter the applicant’s trading name or registered business name, if different from the legal name.

Enter the applicant’s Australian Business Number (ABN) if the applicant has one.

Please provide the first page identifier for the document.

Please provide the second page identifier for the document.

Provide a detailed description of the relief you are seeking by making this application to the Commission, including any specific determination sought if the Commission has the power to arbitrate the dispute.

Check this box if the Applicant(s) have a representative and you need to provide their details.

Check this box if the Applicant(s) do not have a representative and you should proceed to the questions about the Respondent.

Provide details if the representative is neither a lawyer nor a paid agent.

Enter the name of the lawyer representing the applicant.

Enter the name of the paid agent representing the applicant.

Check this box if the applicant's representative is a lawyer.

Check this box if the applicant's representative is a paid agent.

Check this box to confirm that the applicant's representative is either a lawyer or a paid agent.

Check this box to confirm that the applicant's representative is neither a lawyer nor a paid agent.

Enter the name of the firm, company, or organisation representing the applicant.

Enter the Australian Business Number (ABN) of the representative, if applicable.

Enter the full name of the individual who is representing the applicant.

Provide the Australian Business Number (ABN) for the respondent, if applicable.

Enter the trading name or registered business name of the respondent, if applicable.

Enter the full legal name of the respondent business.

Provide the Australian Company Number (ACN) for the respondent if it is a company.

Enter the phone number of the respondent's contact person.

Enter the name of the contact person for the respondent.

Enter the email address of the respondent's contact person.

Enter the full street address for the respondent's postal address.

Enter the suburb for the respondent's postal address.

Enter the postcode for the respondent's postal address.

Enter the state or territory for the respondent's postal address.

Please enter the phone number of the respondent.

Please enter the full postal address of the respondent.

Please provide the email address of the respondent.

Please enter the suburb of the respondent's postal address.

Please enter the surname of the respondent.

Please enter the first name or names of the respondent.

Please enter the state or territory of the respondent's postal address.

Please enter the postcode of the respondent's postal address.

Provide the name of the road transport contractual chain order.

Provide your signature. If completing electronically, type your name here.

Provide your full name.

Provide the date of signing.

Provide the capacity in which you are signing this form, such as 'Applicant', your position title, or 'Representative'.

Please specify the special assistance required for the hearing or conference.

Check this box if you require special assistance at the hearing or conference and will specify the type of assistance needed.

Check this box if you do not require any special assistance at the hearing or conference.

Provide a chronological list, using numbered paragraphs, of the steps already taken to resolve the dispute under the dispute resolution procedure.

Check this box if the application relates to an employer's refusal of a request by an employee for an extension of unpaid parental leave.

Check this box if the application does not relate to an employer's refusal of a request by an employee for an extension of unpaid parental leave.