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Aviation Security Incident Report

A complete report submitted to the Department of Infrastructure, Transport, Regional Development and Local Government using this form and including the required information will fulfil incident reporting obligations under Part 6 of the Aviation Transport Security Act 2004 (ATSA).

The Department should be notified of an incident as soon as possible. Reports can be made either (a) in writing, or (b) orally and followed up in writing within 24 hours. This report should contain as much of the following information as within the knowledge of the person making the report.

Note: All fields marked with an * are mandatory
Report date
  		Your reference number
(for your use only)
 
* 1. Incident Details
* Date of incident
(dd/mm/yyyy)
  		* Time of incident
(24-hr hhmm)
  		* Aviation Industry Participant
(Name of organisation)
 
* Location of incident (Airport Name)
  		* Location of incident (State)
 Airport area
 Terminal number
* 2. Category Security Incident

Please choose the category of incident from the list below which best describes the incident you are reporting. This list should be used as a guide only, it is not exhaustive. For incidents that fall outside of the categories listed below please nominate "other" and provide a brief description.

These categories and sub categories are used by the OTS to assist in the Departments reporting and analysis of security related incidents.
Note: please click the ? for sub-categories.
 
     
 
   
 
     
   (please specify)  
3. Incident Assessment
If you have nominated threat above, please provide the following information:

Assessed As

Assessed by (Name of person)

 Threat received by





  		Tracing
4. Aircraft Information
Did the incident involve an aircraft?
*Aircraft type
 
*Flight number
 

Aircraft registration
Place of departure
  		Place of arrival
 

Was the aircraft in flight?
5. Incident Description
Background - Please provide details leading up to the incident.
 
* Description - Describe the nature of the incident in detail.
 
Action/Outcome - Describe what action you or your organisation took to manage the incident and detail what the outcome was.
 
6. People involved in the incident
Complete the following details for all people involved in the incident (if other people involved).
Full name  Organisation   
Full name  Organisation   
Full name  Organisation   
Click here to expand the fields to add additional contacts.
Full name  Organisation   
Full name  Organisation   
7. Which other organisations have been notified?
Other organisations may include for example; state/territory police, Australian Federal Police, Airservices or other aviation industry participants.
Organisation  Who has been notified  Date    Time   
Organisation  Who has been notified  Date    Time   
Organisation  Who has been notified  Date    Time   
Click here to expand fields to add additional contacts.
Organisation  Who has been notified  Date    Time   
Organisation  Who has been notified  Date    Time   
Complete the following details if you are aware if the incident has been previously reported to the Department.
Person notified in the Department   Date   Time 
* 8. Reason for Report


*Full name
*Organisation
*Contact
 
* 9. Reporting Officer's Contact Details
This section is to be completed by the officer completing the form.
*Full name  *Position 
Organisation  *Phone 
  		Fax   
Email    Check if you don't want the form details sent to your email address.
Street 
City/Suburb   State  Postcode 

   


This electronic form was developed to assist in meeting your incident reporting requirements to the Secretary under the Aviation Transport Security Act 2004. You may make hard copies of this form for the purpose of reporting incidents to the Department of Infrastructure, Transport, Regional Development and Local Government or to the AFP, airport operator(s) and/or airline(s) if applicable.

Alternatively you can email or fax or phone through the report to the Office of Transport Security Coordination Centre:
Email: transport.security@infrastructure.gov.au
Fax: (02) 6274 6089
Phone: 1300 307 288*
*verbal reports must be followed up in writing within 24hrs

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Last Updated: 9 September, 2008