Report an employer - missing work history

Who should use this form?

You can use this form to lodge a request with QLeave about your current or past employer if they:
• are refusing to add service for you, OR
• have failed to record service for you in the past.

Employers that engage eligible workers in Queensland's building and construction, contract cleaning, and community services industry are required under legislation to report their worker’s eligible service to QLeave. If they are not doing this, they may be breaching the legislation.

Please provide as much detail as possible about the employer and the work you performed with them when completing this form. We will use the information you provide to assess your eligibility and notify you of an outcome.

You will need to provide documentation to support your request. Suitable supporting documents include pay slips, income tax returns, tax statements, PAYG statements, group certificates, invoices, and employment contracts. These should display the ABN, payment amounts, and dates of employment for all years related to your request.

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Screening Questions

Have you asked this employer to update your service? *

If you have not discussed your unrecorded service with your employer, you should do so before submitting this form. Contacting your employer will be the fastest way to have your service updated.

• Yes
• No

Did you perform this work in Queensland? *

Only work you have performed in Queensland is eligible under QLeave’s portable long service leave schemes. If you are reporting an employer for work you performed outside of Queensland, the service will not be considered eligible and you should not complete this form.

• Yes
• No

Your details

First Name *

Last Name *

Phone Number

Email Address *

What is your QLeave Registration number (if known)?

Details of unrecorded service

Which industry do you work in? *

• Building and Construction
• Contract Cleaning
• Community Services

For the period of unrecorded service, did you perform cleaning work for more than 50% of your working hours?

Your unrecorded service may not be eligible if you did not perform cleaning work for more than 50% of your working hours. For example, if you spent 80% of your working hours completing administrative tasks and 20% performing cleaning work, your unrecorded service would not be eligible. If you are unsure whether your unrecorded service is eligible, please contact us on 1300 753 283 or email ccicompliance@qleave.qld.gov.au to find out more before completing this form.

• Yes
• No

What was your position title for the period of unrecorded service? e.g. Window Cleaner, Disability Support Worker

What type of work did you perform? *

Air conditioning workerAluminium FixerAsphalt WorkerBoilermakerBricklayerCabinetmakerCable JointerCarpenter/JoinerCarpet LayerChainmanCleaner (new construction)Communication technicianConcrete pumperCrane driverData cable installerElectricianFitterFloor LayerFloor polisher/sanderForeperson/subforepersonFormwork carpenterGangerGarage door installerGlass workerInstrument tradesperson technicianLabourerLaggerLandscaper (hard only)Painter/decoratorPest controllerPlant mechanic (not vehicular)Plant operator/driverPlastererPlumber/drainer/gasfitterPool builder/isntallerPowdercoaterRefrigeration mechanicRigger/splicer/doggerRoof plumberRoof tilerSafety officerSandblasterScaffolderSecurity system installerSheetmetal workerShopfitterShower screen installerSignwriterSprinkler pipe fitterSteelfixerStone masonSurveyor's assistantTilerTrades assistantTraffic controllerTree lopperTruck driver (roadwork)WaterprooferWelderWindow assembler/installer-- Please Select --

How were you engaged by the employer? *

-- Please Select --Employee (PAYG)Sole Trader - Contractor/subcontractorLabour Hire WorkerPartner in a PartnershipTrustee of a TrustWorking Director of a company

What was your type of employment?

• Full-time employee
• Part-time employee
• Casual employee
• Sub-contractor

What is the start date of the period of unrecorded service? *

What is the end date for the period of unrecorded service?

How many days did you work during this period?

Employer details

What is the employer's business name? *

What is the employer’s legal entity name (if known)?

What is the employer’s Australian Business Number (ABN)? *

What is the employer’s email address?

What phone number should we use to contact the employer? *

Supporting documents

Please upload supporting documentation * Please attach documents showing that you were engaged as a worker for the period of unrecorded service.
Examples of accepted supporting documents include:
• pay slips
• tax statements
• invoices

We will accept a combination of the above, as long as they cover the period of unrecorded service you are reporting. The documents should show the ABN you were engaged under, the period of engagement, your rate of pay and position title.

Note – Under each of the relevant Acts, worker registration and eligible service must meet various provisions. For QLeave to be satisfied the unrecorded service is eligible, we need to see evidence of work performed. We do not determine what type of document is required, however you do need to supply documents that will allow us to determine whether your unrecorded service is eligible.

Declaration

I certify that the information provided is true and correct to the best of my knowledge. *

• Yes
• No