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Form 1

Notice to Centrelink of proposed dismissals

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Schedule 3.4Forms for certain dismissals

Form 1 Notice to Centrelink of proposed dismissals

(regulation 3.30)

Fair Work Act 2009, section 530

NOTICE TO CENTRELINK OF PROPOSED DISMISSALS

TO: CENTRELINK

I, [full name of employer or person completing notice on behalf of employer], the [position held] of [name of employer of person completing notice], give notice, under subsection 530(1) of the Fair Work Act 2009, that [name of employer] proposes to dismiss the employment of 15 or more of its employees, for the following reasons:

[Set out reasons for proposed dismissals. Reasons may be of an economic, technological, structural or similar nature, or for reasons including such reasons]

The number and categories of employees likely to be affected by the proposal are:

[Set out the categories and number per category]

It is intended that [name of employer] will carry out the proposed dismissals at the following time/s, or over the following period/s of time:

[Provide specific dates if known, or approximate period of time]

Dated 20

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