EOP Document Upload

Consent and Authorisation

I hereby consent to Affordable Interlock Systems Pty Ltd to view my documents so that I may successfully apply to have the alcohol interlock removed from my vehicle. I understand that Affordable Interlock Systems need the information as part of their removal process.

Privacy Statement

Affordable Interlock Systems privacy statement can be viewed at www.affordableinterlocks.com.au

Tick the Boxes

Please Confirm the Following by Ticking the Boxes

I Understand That:

I confirm that I have received a Program Completion Notice and acknowledge if the interlock is removed before receiving the Program Completion Notice and I will need to pay to reinstall the alcohol interlock.

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First Name *

Last Name *

Email Address *

Vehicle Registration Number *

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Date

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AIS-NET-O-005

02MAR2021 V1.0