Instructions for completion
Affidavit of Service (Fair Work – small claims proceedings)
1.	This form of affidavit of service may be used as evidence of service for the purpose of rule 6.05 of the Federal Circuit and Family Court of Australia (Division 2) (General Federal Law) Rules 2021 (the Rules) in any Fair Work proceeding under section 548 of the Fair Work Act 2009. 
2.	This affidavit of service must be sworn or affirmed before a person authorised by law to witness the swearing of affidavits; for example, a lawyer, notary public or Justice of the Peace.
3.	Each page must be signed by the deponent (the person making the affidavit).
4.	Any alteration in the affidavit of service must be initialled by the deponent and the witness.
5.	You must complete address for service details in the footer on page 1. 
6.	If the facts in the affidavit of service are supported by a document, a copy of the document must be attached to this affidavit of service. This document is then referred to as an ‘annexure’. If there is more than one annexure refer to each by a number or letter; for example – 'Annexure 1' or 'Annexure A'. The annexure should also have page numbers. If there is more than one annexure, the page numbers must run consecutively until the last page of the last annexure.  If it is impractical to annex a document, it may be separately identified as an exhibit: see rule 15.15.
7.	Each annexure must include a statement signed by the witness identifying the annexure as the document referred to in this affidavit. The wording of the statement is as follows:
This is the document referred to as [insert annexure identification] in the affidavit of [insert deponent's name] sworn/affirmed at [insert place] on [insert date] before me [witness to sign and provide name and qualification].
The statement must be signed at the same time as the affidavit and by the same witness.
8.	Once complete, you need to file the original with the court registry and keep a copy for your records.  

Remove this instruction sheet before filing

IN THE FEDERAL CIRCUIT AND 
FAMILY COURT OF AUSTRALIA
REGISTRY: ..................................
	COURT FILE NO: .................................	

........................................................
Applicant
........................................................
Respondent
........................................................
Second Respondent (if applicable)
Repeat as necessary for additional parties

Affidavit of Service (Fair Work – small claims proceedings)
1.	Person serving documents
Full name ..........................................................
Occupation ........................................................
Address (incl postcode) ..............................................................................................................
2.	Person served
Full name ..........................................................
3.	Date documents served ......../........./.........
4.	What documents were served? (cross box if applicable)
	(a)	APPLICATION—FAIR WORK DIVISION
	(b)	FORM 5 Small claim under the Fair Work Act 2009—paragraph 30.11(b)
dated ......../........./.........
	(c)	FORM 5A Small claim (casual conversion dispute) under the Fair Work Act 2009—paragraph 30.11(b)
dated ......../........./.........
	(d)	Affidavit of ...................................................
sworn/affirmed on ......../........./.........
	(e)	Other ..........................................................

5.	How were they served on the person?  (cross box if applicable)
	I handed them to the RESPONDENT at (address) ..............................................................................................................................................
	I attempted to hand them to the RESPONDENT at (address) 
`..............................................................................................................................................
	The RESPONDENT refused to accept them.  I put them down and left them in the presence of the person and said to the person
..............................................................................................................................................

6.	(FOR A RESPONDENT CORPORATION)  (cross box if applicable)
	I posted them by pre-paid post in an envelope addressed to the RESPONDENT, to the registered office of the RESPONDENT: or
	I delivered them to the registered office of the RESPONDENT: 
(Address of registered office) 
...............................................................................................................................................

7.	How was the person served identified? (Note - do not complete if service was by post to a corporation)
	I know the person served
	The person is shown in the attached photograph
	I had the following conversation with the person on (date) ......../........./.........
(set out conversation relating to person’s identity)
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................

I swear/ affirm that the facts set out above are true.

Sworn / Affirmed by the deponent			
at ..........................................................			
on ......../........./.........		Signature of deponent	
Before me:			
			
Signature of witness			
Full name of witness:  ..........................................................	
Qualification of witness:  ......................................................
eg Lawyer or JP 	

GFL_FW_AffidavitService_0921V1