Please fill out the fields below

Your Name (first and last) (required)

Your Email (required)

Your contact phone number (required)

Your City/Suburb/Town (required)

Your State (required)
Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia

What was the name of your employer? (required)

How many employees does the employer have?
less than 15more than 15

what date did you start employment? (required) (dd/mm/yyyy)

what date were you dismissed? (required) (dd/mm/yyyy)

NOTE: you must lodge a claim with the Fair Work Commission within 21 Days from the date of dismissal. A failure to lodge within 21 days may cause your application to be rejected and any claim to be denied.

What was your job title when you were dismissed?

What was your annual earnings at the date of dismissal?
less than $142,000.00more than $142,000.00

What basis were you employed?
CasualContractorPart-TimeFull-Time

What was the reason/s stated for your dismissal? (required)

Why do you dispute the stated reason/s for your dismissal?
Please provide relevant dates and details for conversations and emails relating to the reason for your dismissal. Feel free to attach additional pages if necessary.

Were you given any warnings (verbal or written) about your conduct or performance at work during your employment? (required)
NoYes

What was your (gross) weekly pay? (whole dollars) (required)

Were you paid notice in lieu of your dismissal?
YesNo

Have you been paid all entitlements owing to you? (annual leave, leave loading, long service leave, superannuation)
YesNo

Have you filed any other claims or applications with the Fair Work Commission or any other organisation in relation to your dismissal?
NoYes

Please provide copies of any relevant contracts of employment, policies and procedures or other relevant documentation. Please tick the relevant box of the documents you will be providing to Cate & Cº Lawyers and Associates.
Contract of EmploymentEnterprise Agreement/Collective AgreementFinal Pay PayslipRelevant PoliciesTermination of Employment Letter/EmailAllegation LetterWritten response to the Allegation LetterSeparation CertificateOther

Choose files to upload

Any other information?

Terms and Conditions

1: I confirm that by clicking this box the information is true and correct within my knowledge.
2: I acknowledge I have been given notice that an application must be filed in the Fair Work Commission within 21 days of dismissal.
3: I acknowledge that by completing this online form at this stage I have not engaged Cate & Cº Lawyers and Associates to act in connection with my proposed unfair/unlawful dismissal matter.
4: I acknowledge that I have NOT received advice from Cate and Cº Lawyers and Associates, until I have engaged them to represent me.

Δ