Certifies emergency after-hours electrical repairs so the network provider can reconnect the property when the after-hours crew cannot see the online CoC system. A licensed electrical worker and the contractor licence holder (or authorised person) both sign, and you leave with a PDF the connection crew can accept on the spot. NT WorkSafe limits this form to that reconnection situation; ordinary electrical work still uses the normal certificate process.
This is the current NT WorkSafe emergency after-hours repairs certificate. Tradie Forms follows the official section order and maps your answers onto the official PDF layout.
Capturing ESS, EV, solar or inverter detail for a hard-copy NT CoC rather than an after-hours reconnection? Use NT CoC Addendum
This form is only for emergency after-hours repairs that need a certificate in the network provider's hand before reconnection. Have these ready on site.
Confirmation this is the right certificate
The network provider needs a paper CoC for after-hours reconnection, not a standard online-only lodgement.
Customer and site identity
Who called you out, a phone number that reaches them tonight, and the address of the installation you repaired.
Owner details when they differ
On rentals and managed sites, the owner name and email if the customer is a tenant or agent.
What you found and fixed
The fault, the repair you completed, and the date work finished, written while the job is still clear.
Any unrepaired non-compliance
Defects you observed but did not fix, with the standard and clause number if you will answer Yes on the form.
Worker and contractor licence details
Current electrical worker and contractor licence numbers for the people who will sign.
Download is blocked until customer name, repair date and description, both licence blocks (names and numbers), both signature dates, and both signatures are complete. Property address is not a schema gate, but the PDF is useless for reconnection without the installation address the crew will use.
Customer contact details and the property where the emergency repairs were completed. The same customer and property wording should carry into the online CoC you lodge later, so a mismatch between the night record and the portal becomes a query weeks on.
The form opens with an official notice: this certificate is for emergency after-hours repairs before network reconnection, you must also submit through the NT online CoC service, and the form does not satisfy section 41(4)(a) and (b) of the Electrical Safety Act 2022.
Customer NameTextRequired
Who the work was for. On a business callout, put the business name and the primary contact, for example Top End Apartments - night manager Priya Nair. The network crew and the later online CoC both need a clear contact, not only a trading name.
Customer PhoneTelOptional
A number that reaches the customer tonight, such as 0412 345 678. Prefer a mobile answered on site over a switchboard that only takes messages.
Customer EmailEmailOptional
Useful for the online CoC copy and for follow-up on unrepaired defects. Use a monitored address when the customer is a business or agent.
Street addressAddressOptional
Where the electrical work was completed, not the account holder's postal address if those differ. Address search is limited to the Northern Territory and fills the street line, suburb, state and postcode. Check the result against the site you worked on; a unit, meter or building that is not in the search result still needs typing by hand.
StateAddressOptional
Filled by address search for NT results. Confirm NT when you type the address manually.
PostcodeAddressOptional
From address search or the site. Keep it with the street line so the composed property address on the PDF is complete.
Save this section as Customer to prefill it on your next emergency after-hours CoC for the same customer.
The street, suburb, state and postcode are composed into one property address field on the official PDF. Preview that line before you hand the PDF to the crew.
Complete when the property owner is known and different from the customer. On many after-hours callouts the tenant or managing agent is the customer; the owner is still who section 41 expects to receive a CoC for the work.
Property Owner NameTextOptional
The owner when they are not the customer, for example the landlord or owners corporation. Leave blank when the customer is the owner. Recording it here is what lets you close the owner copy when you lodge the online CoC.
Property Owner EmailEmailOptional
How to reach that owner for the later CoC and any defect follow-up. Skip it when the owner section is empty.
When the emergency repairs finished and what you did. Write this for someone reading cold when the online CoC is lodged, not only for the crew on the night.
Repairs Completed DateDateRequired
The date the emergency repairs were finished on site. Today and Yesterday shortcuts are there because this is usually filled immediately after the job. The field does not accept a future date.
Description of RepairsTextRequired
Describe the fault you found and the work you carried out to make the installation safe and restore supply. Name the circuit, equipment or part of the installation when you can. This is the wording you will want again in the online CoC, so a clear description now saves reconstructing the job later.
Useful
Replaced damaged consumer mains connection and restored supply after storm damage
Records defects or non-compliances you saw on the existing installation that you did not repair. Emergency work restores safe supply; it does not rewire the house at 2am. Answering Yes and naming the standard is documenting what remains, not admitting an incomplete job.
Were there any defects or non-compliances observed on the existing installation which were not repaired?ChoiceOptional
Answer Yes or No from what you observed. Nothing blocks download if you leave this unset, but an empty answer when you did see a problem is the gap that comes back later. Choose No only when you saw nothing unrepaired that needed noting.
Non-Compliance DetailsTextOptional
Required by the form when you answer Yes. Include the standard and clause number for each non-compliance, plus enough location detail that a daytime crew can find it. The app blocks download if Yes is selected and this box is empty.
Useful
No RCD protection on the lighting subcircuit, AS/NZS 3000:2018 clause 2.6.2. Advised customer, outside scope of emergency repair.
Certification by the electrical worker who carried out the examinations and tests. The section wording on the form is that the information is complete and correct, that you carried out the examinations and tests on the work detailed, and that the results satisfy the Electrical Safety Act 2022.
Electrical Worker NameTextRequired
The licensed person who tested the work. Use the name on the licence card, not a workshop nickname. On a one-person job this may be the same person as the contractor declaration; both blocks still need completing.
Electrical Worker Licence NumberTextRequired
From the current electrical worker licence, for example EL123456. Check it against the card or renewal notice before you sign in the dark.
SignatureSignatureOptional
The worker's mark that the examinations and tests were done and the results satisfy the Act. Capture it on site after the repair description and defect answers are correct. You can use a saved signature; check the preview so the stamp sits cleanly in the signature box. The form will not download without it.
DateDateRequired
The date the worker signs. Today and Yesterday shortcuts are available. The field does not accept a future date.
Save this section as Electrical Worker to prefill it on your next emergency after-hours CoC for the same worker.
Certification by the contractor licence holder, or an authorised person acting on the contractor's behalf. The form wording is that the information is complete and correct and that the contractor managed the electrical work so it meets the Electrical Safety Act 2022.
Contractor Licence Holder NameTextRequired
The contractor licence holder name as licensed, for example Top End Electrical Pty Ltd, or the authorised person signing for them. This is a different role from the electrical worker even when one person holds both licences.
Contractor Licence NumberTextRequired
The contractor licence number from the current card or renewal, for example EC789012. Do not paste the worker licence number into this field by habit.
Contractor PhoneTelOptional
Office or mobile contact for the contractor, such as 08 8941 2200. Useful for network or WorkSafe follow-up after reconnection.
Contractor EmailEmailOptional
Contractor email for the job file and online CoC lodgement, for example the office inbox that holds certificate copies.
SignatureSignatureOptional
The contractor (or authorised person) mark that the work was managed to meet the Act. Sign after the worker block and the repair and defect answers are correct. You can use a saved signature; check the preview. The form will not download without it.
DateDateRequired
The date the contractor signs. Today and Yesterday shortcuts are available. The field does not accept a future date.
Save this section as Contractor to prefill it on your next emergency after-hours CoC for the same contractor.
Interstate electricians still need authority to certify work done in the Territory. Sort that before you sign either declaration.
The emergency certificate exists because after-hours network crews cannot see the online CoC. Daytime work and non-reconnection jobs use the normal certificate process.
Treating the emergency PDF as the full CoC duty.
Section 41(4)(a) and (b) still require the online CoC path for the owner, occupier, and person the work was for. Reconnection is step one, not the finish.
Putting the account postal address instead of the installation.
The property line is where the electrical work was completed. A mismatch with the later online CoC is a common query weeks after the callout.
Writing a vague repair description.
Fixed power means nothing when you rebuild the online CoC or when someone reads the file months later. Name the fault and the repair.
Answering Yes to unrepaired defects without the standard and clause.
The form asks for the standard and clause number. Vague notes fail the download when Yes is selected, and they fail the next crew who cannot find the defect.
Leaving unrepaired defects blank when you saw them.
Emergency scope is not a reason to hide what remains. Note what you saw, cite the clause, and tell the customer what needs a planned visit.
Copying the worker licence number into the contractor field.
Worker and contractor are separate declarations under the Act. Wrong numbers on either side undermine both signatures.
Signing before the repair and defect answers are final.
Both signatures attest that the information on the certificate is complete and correct. Change the wording, then sign.
Give the finished PDF to the network provider before reconnection where the emergency process requires it. That is the reason the form exists on the night.
Name the file so the night job is obvious. Include the suburb or street and after-hours so it is not mistaken for a routine CoC in the job folder.
File it with the later online CoC. Keep the emergency PDF, the online certificate, photos, and any defect follow-up in one job record so the two certificates read as one job with two steps.
Track unrepaired defects. If you answered Yes, book or note the planned rectification so the clause you cited is not lost after reconnection.
Keep the contractor copy.NT WorkSafe certificate guidance expects certificate records to be retained; check the current retention period and keep at least the contractor copy with the job file.
Tradie Forms prepares the PDF but does not send it to the network provider or NT WorkSafe. Check the current NT WorkSafe and Power and Water requirements before reconnection and distribution.
