Official form guide
Form request for flexible working arrangements example letters st: Request for flexible working arrangements example letters sts
This Fair Work Ombudsman resource provides example letters that employees can copy to request flexible working arrangements under the Fair Work Act. Use it when you need to ask your employer for a change to your hours, days or work pattern.
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Form Overview
Fair Work Ombudsman Form request for flexible working arrangements example letters st - Request for flexible working arrangements example letters sts
This Fair Work Ombudsman resource provides example letters that employees can copy to request flexible working arrangements under the Fair Work Act. Use it when you need to ask your employer for a change to your hours, days or work pattern.
Risk Radar
Scan points- 1Missing the 21‑day written response request is a common slip‑up.
- 2Not stating the legal eligibility basis (e.g., parent of a child under school age)
- 3Leaving out the requested start date
- 4Failing to ask for a written response within 21 days
- 5Not signing the letter
Plain English
Think of it as a ready‑made template you can edit with your own details. It helps you write a clear, legal request that matches the rules in the National Employment Standards.
Submission Date
- Filing date: Send the request as soon as you need the change; the employer must reply in writing within 21 days of receiving it.
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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What this form is for
- When you need a template to write your own flexible‑working request under the Fair Work Act.
- If you are eligible under the National Employment Standards (NES) and want a starting point.
- When you prefer a written request that includes the required legal references.
- If you want to see how to structure the request, dates and response timeframe.
Form selector
Use this form or another form?
Parental leave request
Specific leave entitlement, not flexible hours
✓ Verify you need leave, not a work‑pattern change
Parental leave application form (Fair Work)
Request for reduced hours due to health
Health‑related entitlement may require doctor evidence
✓ Check medical evidence requirement
Medical certificate and flexible‑work request template
Change of employment contract
Formal contract change, not just a request letter
✓ Confirm employer agrees to sign a new contract
New contract or amendment document
Deadline or filing window
The employer must give you a written decision within 21 days of receiving your request.
Before you submit
- 1Include your full name, contact number and role.
- 2State the exact change you are requesting (hours, days, start time).
- 3Provide your eligibility reason (e.g., parent of child under school age).
- 4Confirm you have 12 months continuous service.
- 5Specify the proposed start date and whether it is ongoing.
- 6Add a request for a written response within 21 days.
- 7Offer a discussion time and include your phone number.
- 8Proofread for personal details and dates.
- 9Save a copy for your records.
How to file this form
- 1Download the Fair Work Ombudsman flexible‑work template from fairwork.gov.au/templates.
- 2Replace the example text with your own details following the structure shown.
- 3Add any extra information required by your award or contract.
- 4Send the letter to your employer (email or hard copy) and keep a copy.
- 5Record the date you sent the request.
Known limitations
- 1It is only an example letter, not a legal form.
- 2Does not guarantee the employer must approve the request.
- 3Does not replace the need to check your award or enterprise agreement.
- 4Employer may have additional internal procedures.
- 5Not a substitute for professional advice if you are unsure.
Field map
Compact field-by-field guide
Applicant
1 items
Full name (and representative, if any), postal address, email, and phone number of the person or organisation lodging the application.
Respondent
1 items
The exact legal name and ABN of the employer or other party the application is made against.
The Matter
2 items
Identify the kind of matter — for example, unfair dismissal, general protections, or an agreement application.
A clear description of what happened, relevant dates, and the outcome you are seeking.
Dates
1 items
Relevant dates such as the date of dismissal or the date the issue arose — these determine whether you are within time.
Supporting
1 items
Any documents that support your application, such as letters, contracts, or notices.
Declaration
1 items
Sign and date the form. Applications may also require a fee or an application for a fee waiver.
Almost done reviewing the fields?
Fillable formOpen in Editor->The resource was last updated in August 2023 and is an example letter, not a mandatory submission form.
What changed or needs a fresh check
- Confirm the document shows the August 2023 update stamp.
- Check that the example includes section 65(1) reference.
- Verify eligibility statements match your situation.
- Ensure the 21‑day response period is still current.
Quick Facts
Sources
- SRCLast updated August 2023confirmed in source.
- SRCEligibility: parent of child under school ageconfirmed in example letter 1.
- SRCSection 65(1) referenceconfirmed in both example letters.
- SRC21‑day written response requirementconfirmed in example letter 1.
- SRCContact infoline 13 13 94confirmed on page 1 and page 2.
- SRCTemplate availability at fairwork.gov.au/templatesconfirmed on page 1.
- SRCNot confirmed in official source: exact alternate form names for health‑related requests.
Common confusion points
Using the example text verbatim without personalising details.
Omitting the 12‑month continuous service requirement.
Failing to reference section 65(1) of the Fair Work Act.
Not stating the 21‑day response timeframe.
Leaving out contact details for follow‑up.
Confusing flexible‑work eligibility with other leave types.
Source transparency
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