Informal Review Form - TAC - Transport Accident Commission

Required fields are marked with an asterisk (*).

Your details

Who is completing this form? *

I am the TAC client
I am completing the form on behalf of the TAC client

You are completing this form on behalf of the client, please provide us with your details.

Your name

Your address

Your postcode

Your relationship to the TAC client

Your contact number

TAC Client name *

TAC claim number *

How would you like to be contacted *

phone
email
post

Prefered contact number

Authorisation

Do you want the TAC to talk to someone else about this Informal Review? *

Who do you give us authority to talk to about your review You can revoke permission for the TAC to discuss your Informal Review with this nominated person at any time by contacting us

Request for review details

You have 12 months from the date you become aware of the TAC’s decision to ask for an informal review.

Decision date * Day Month Year

Decision type *

If other, please provide more detail

Please explain the reasons why you believe the TAC’s decision is incorrect *

Please provide us details of any further information you would like the review officer to consider *

Please tell us what outcome you believe would be fair to resolve your issue *

Please feel free to upload any additional information

Upload files

Additional file

Your privacy
The TAC respects your privacy. The TAC will retain this information and may use or disclose it to make further inquiries or assist in the ongoing management of the claim or any claim for common law damages. The TAC may also be required by law to disclose this information.
If you require further information about our privacy policy, please call the TAC on 1300 654 329 or visit our privacy policy.