Certificate of Compliance

Electrical Worker's Details

Name of Electrical Worker

Registration/Practising License Number

Phone/Email

Owner/Occupier's Details

Owner/Occupier's Name

Installation Address
Start Date of Electrical Work
Finish Date of Electrical Work
Details of Work Completed

General Description of Work

The following detailed information must also be provided - indicate the number or rating in each category

Lights

Socket outlets

Cooking appliances

Water heaters

Motors

Air conditioners

RCDs

Smoke Alarms

Details of RCD Protection

Are all the socket outlet and lighting final subcircuits of the installation are protected by at least two RCDs?

If NO, what circuits are not protected?

Details of any defects observed (alterations and additions only)

Electrical Safety Certificate

By signing this document I certify that the electrical installing work that is subject of this certificate has been completed, checked and tested , and at the time of testing, met the requirements of the regulations and is safe.

Certifier's Name

Registration/Practicing License Number

Certification Issue Date
Connection Date
Certifier's Signature