Notifying result of election of a safety and health representative

Safety and health representative(s) notification of election form - 58 Kb

This form is for safety and health representatives regarding the notification of election.

Who is responsible for the notification?

The person conducting an election for a safety and health representative must notify the State Mining Engineer of the results of the election. This is done by submitting the notification of election form no later than 7 days after the election date.

A separate form is required for each elected person.

Refer to s. 56 of the Mines Safety and Inspection Act 1994

The person conducting an election must also notify the person elected as a safety and health representative and the employer.

Lodging the notification

For electronic submission either:

The notification form can also be mailed to:

Resources Safety
The Department of Mines, Industry Regulation and Safety
Mineral House 100 Plain Street
East Perth WA 6004

Or lodged in person at Resources Safety, 1 Adelaide Terrace, East Perth

Related information

Below is a related document that you may find useful.


For enquiries please contact an inspector of mines.
Phone: 1800SAFEMINE (1800 7233 6463)