Form
Form XI
Form XI — Notice of accident or dangerous occurrence
Form-level filing, reconciliation and evidence guide.
Purpose and filing control
Purpose
Notice of accident or dangerous occurrence
Referenced by
Rule 7
Owner
Employer, contractor, manager, authorised signatory or competent authority according to the form
Submission mode
Electronic portal where prescribed; retain generated acknowledgement and signed source data
Source review
2026-07-17
Preparation checklist
- Use the Gazette format and do not omit mandatory fields merely because a portal screen differs.
- Reconcile identity, establishment, worker, wage, safety and licence data to source systems.
- Attach supporting evidence and preserve the maker-checker approval.
- Record submission time, transaction ID and authority acknowledgement.
- Correct errors through the authorised amendment route rather than overwriting the original filing.
Linked Rules
Evidence file
- Completed form/export
- Source-data reconciliation
- Attachments and authorisation
- Portal transaction and acknowledgement
- Correction or amendment history