Planning and Development Act 2007, s425 
Construction Occupations (Licensing) Act 2004, s128 
Controlled Activity/Construction Occupations Complaint Form

This form is to be used should you believe that there has been a breach by a licensee or former licensee under the Construction Occupations (Licensing) Act 2004 (COLA), or an operational Act; and/or a person is conducting or has conducted a controlled activity under the Planning and Development Act 2007 (PDA).  Fields marked with an (*) must be completed.

Before completing this form please read the fact sheet on Development and Construction Occupation Complaints which provides information about breaches of COLA and Controlled Activities.

All reasonable steps will be taken to investigate your complaint. 
Please note:
•	You may be required to provide further information as part of the investigation process.
•	Complaints are prioritised based on the risk to public safety.
•	Investigation and action on your complaint may take a significant amount of time to be completed.
•	You will be kept informed of the progress of the investigation.

The completed form can be submitted by email to actplalru@act.gov.au or mailed to ACTPLA Investigation Unit, GPO Box 1908, Canberra City, ACT, 2601.

1. Contact details	

*Your Name(s)			

*Address	

*Contact Number					Email:

2. Site details (subject of complaint)	

Unit			Block			Section		Suburb

*Street Address	

3. * Summary of complaint	

Unlawful Development	Breach of Lease	
		
 Development without Approval	Unclean Leasehold	
 Development not in accordance with approval	Unlawful Use	
		
Construction Work	Licensee	
		
 	Building	 	Unlicensed	
 	Electrical	 	Licence Breach	
 	Plumbing		Building Certifier	
 	Gas		Works Assessor	

4. * Complaint details ( full description of the complaint. Attach any technical reports or associated material)	

5. Privacy Note	

The personal information on this form is being collected to enable processing of your complaint. 
Collection of personal information is authorised by Part 11of the Construction Occupations (Licensing) Act 2004 and Chapter 11 of the Planning and Development Act 2007.

6. Acknowledgement 	

I/we the undersigned acknowledge that I/we have read and understood the details outlined on this form.  I/we acknowledge that this complaint, including the personal information provided on this form, may be referred to another ACT Government Agency or ACT Policing for the purposes of investigating the complaint or a breach of another law.  I/we declare that all the information given on this form and its attachments is true and correct.

*Signature(s)								*Date