Maritime security incident report form

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A completed report submitted to the Department of Infrastructure and Regional Development using this form will fulfil incident reporting obligations under Part 9 of the Maritime Transport and Offshore Facilities Security Act 2003 (MTOFSA).

This form may be used to assist in making reports to police and other Maritime Industry Participants (MIPs) or Offshore Industry Participants (OIPs).

A maritime security incident under Part 9 of the Maritime Transport and Offshore Facilities Security Act 2003 should be reported in writing, or orally and followed up in writing, as soon as possible. The optimal time for receipt of an incident report by the Department is within 24 hours of the transport security incident occurring.

  • You can either use the word version DOC: 104 KB PDF: 159 KB and email or fax it to the department (contact details are on the form) or fill out and submit the online form below.

All fields marked with a asterisk must be completed.

Incident details

           



 









Ship details

Building/structure identifier

Incident narrative and response taken

Others involved

Has the incident been reported to

   

If no, please report the incident to those parties in accordance with Part 9, Division 4 of the MTOFSA.

Details of person completing report

           

Other relevant information

Purpose of submitting this form is to notify the Department's Transport Security Coordination team of a maritime transport security incident or other maritime security event.

Purpose of submitting this form is to provide a report of a maritime transport security incident or other maritime security event.