Bush fire hazard - Public Reporting Form

Personal details

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

SuburbState

Post code

Phone Number

Area CodePhone Number

Mobile phone

Email*

example@example.com

Bush fire hazard

Name of owner (if known)

First NameLast Name

Local Government Area*

Address

Street Address

SuburbState

Post code

I am the owner or occupier of land adjacent to or in the vicinity of the above property. I wish to complain of a bush fire hazard that I believe exists on land adjacent to or in the vicinity of my property. The grounds for my complaint are as follows:

I request that the NSW Rural Fire Service investigate my complaint and inform me of actions to be taken in respect of the complaint.

Please note: By submitting this form you are effectively signing this document.

Privacy Disclaimer: The RFS will collect and hold the information you provide it in this form in order to investigate your hazard complaint and determine any appropriate outcomes in accordance with Part 4, Division 2A of the Rural Fires Act 1997. The information will be shared internally at RFS between District, Area and Head Office, in order to deal with your complaint. It may be necessary to disclose the information to external government agencies to enable the RFS to deal with your complaint. The RFS may also use your information for additional purposes, being reporting, process improvement and training. Your provision of this information is voluntary, however we may not be able to investigate your hazard complaint without it. You have a right to access and/or correct this information. Please contact strategichazardsmanagement@rfs.nsw.gov.au if you wish to do so.