---
title: "Service and Contact Person form"
source: "https://www.digitalidsystem.gov.au/sites/default/files/2024-11/service_and_contact_person_form.pdf"
collection: "digital-id-accreditation"
guidance_commit: "db3111cd9d11643ac08b34b4d75b0d0d983ca388"
---

Service and Contact Person
form
This form is used to provide the Australian Competition and Consumer Commission, in its
role as the Digital ID Regulator, with key information about a service:
    •   seeking to be, or already, accredited under the Digital ID Act 2024, or
    •   seeking approval, or already approved, to participate in the Australian Government
        Digital ID System (AGDIS) under the Digital ID Act 2024.

An organisation should use this form to provide information about:
    •   the service
    •   the contact person/s for the service (Service Contact/s).

When submitting applications relating to accreditation or approval to participate in the
AGDIS, an organisation can reattach a submitted Service and Contact Person form to
identify the service that the application relates to.

Where an organisation holds existing accreditation or approval to participate in the AGDIS,
this form can be used to update the details of the Service Contacts assigned by the
organisation.
All items marked with an asterisk * are mandatory.


Organisation details

Organisation name*


Service details

Service name*


If granted, this will be the name displayed on the Accreditation and/or AGDIS Registers and
should accurately reflect the displayed name of the service.

Service type*

Service ABN (if applicable)*

Service description (include as much detail as possible, including what the service is used
for).*


AGDIS approval related applications only

Describe the users of the service (including whether they are individuals or business).*


If used by business, specify if this includes sole traders.*
Service Contact/s
First name

Last name

Position

Work email

24/7 phone (optional)


First name

Last name

Position

Work email

24/7 phone (optional)


First name

Last name

Position

Work email

24/7 phone (optional)


Form completed by

First name Last name    Position

Date