Toll notice nomination dispute form

Use this form to lodge a request to identify who has nominated you for a toll notice.

This form must be lodged within 7 days of the toll notice issue date (found on the top left hand side of the toll notice). Allow up to 20 business days for confirmation of the outcome of your request.

Please note due to privacy restrictions, only the name of the individual will be disclosed.

The information you submit to us is covered by our privacy and security policy.

Complete the fields below (must be exactly as shown on the toll notice)

Contact Details
We will confirm the outcome of our investigation to you via email, please ensure you enter a valid email address.
Mailing Address – as it appears on the toll notice
*Reason for the nomination dispute
(Support file type: jpg/png/pdf, max file size: 5Mb)
*denotes mandatory fields