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Claim for compensation for a work-related death (SRC 184)


This form is to be completed if you wish to claim compensation under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act) for the work-related death of an Australian or ACT Government employee.

Available formats

Last updated: May 2016

If you would like to request this publication in a different format to what is available for download (above), or the publication is not currently available for download, please refer to:

Page last updated: 17 May 2016