RECORDS TRANSFER FORM FOR FUNDED ORGANISATIONS

Funded Organisations must complete and submit this form when transferring records to the Department of Communities, Child Safety and Disability Services. 
Funded organisations must ensure that the records being transferred only relate to service users who have been subject to Child Protection Act 1999
For further assistance: 
Call 1300 747 435 (Select option 2) or email Recordkeeping_Support@Communities.qld.qov.au	

FUNDED ORGANISATION’S DETAILS 	
Organisation Name: 
	
Address: 
	
Contact Name: 	
Contact Email:
	
Contact Phone No:	Date of Transfer:	

RECORDS TO BE TRANSFERRED DETAILS	
	Paper Records	Number of Boxes:
	
	Electronic / Digital Records	Number of Devices:
	Type of Devices:
	CD/DVD
	USB 
	External Hard Drive	

DEPARTMENT’S ACKNOWLEDGEMENT OF RECEIPT	
Name: 
	Position Title: 
	
Signature:
	Date Records Received: 

Privacy Statement
The Department of Communities, Child Safety and Disability Services is collecting the information on this form to meet the requirements of the Child Protection Act 1999 and Public Records Act 2002. The Department of Communities, Child Safety and Disability Services will not disclose any of the information collected to any person, body or organisation unless legislation allows or requires this or you have given your permission.