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Report Release Form (Court Ordered)

All fields are required to be completed before form can be submitted

Participant Information

Alcohol Education Agency Information

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Yes No

Smart Start Interlocks does not send reports directly to the courts. Reports will be sent to your driver education agency and yourself, or both upon request

Under the current re-licencing scheme, Smart Start Interlocks is required to release alcohol data to clients selected Victorian Accredited Driver Education Agency, who are responsible for providing assessments to the Magistrates Court & Vic Roads. By completing this form and entering the email address tied to my Smart Start Interlock account, I hereby authorise Smart Start Interlocks to release reports that contain data on the use of the equipment and any other information pertaining to the clients participation in, compliance or non-compliance with the requirements of the Victorian Court Ordered Interlock Program.

To confirm your identity, please supply the email address associated with your Smart Start Interlock account