6Traffic History#

Have you (in Qld or elsewhere):

• (a) ever had your driver licence suspended or cancelled?
• (b) ever been disqualified from holding or obtaining a driver licence?
• (c) in the last five years, received a notice in relation to any traffic offence other than parking? (for example, speeding, failure to give way)

No Yes You are required to give full details If insufficient room – attach separate sheet.