HSE OFFICER APPROVAL APPLICATION

For New Registration:Below documents to be scanned in color and submitted in a CD

1. Copy of passport with valid visa page2. Passport-size photograph3. Detailed CV4. Copy of attested educational

certificates5. Copy of experience certificate(s)6. Copy of HSE qualification certificates

For Renewal:1. Copy of passport with valid visa page

For Employer Change: 1. Copy of passport with valid visa page2. Existing registration card (if not expired)

For Upgrade Position:1. Copy of passport with valid visa page2. Existing registration card (if not expired)

For Replacement of Lost / Damaged Card:NA

For Linking/Delinking Plots: 1. Link Delink2. If Link, Plot No(s). to be linked:

If Delink, Plot No(s). to be delinked:

For HSE Officer App Username Change:1. Copy of passport with valid visa page

(if not submitted previously)2. Existing username (e-mail address)

New username (e-mail address)

Plot No. HSE Officer's ID No. (if any)

Contractor Name

Submission Type

New Registration Renewal Employer ChangeUpgrade Position

Replacement Of Lost/Damaged Card Linking/ Delinking PlotsHSE Officer App Username Change

DOCUMENTS REQUIRED

SR. NAME OF INSTITUTION LOCATION COURSEPERIOD

FROM TO

QUALIFICATIONS:

ZA-DC-F-34 Issue 7, Rev 1, Dated 18/12/2018 Page 1 of 2

PO Box 478844, Dubai, UAET +971 800-4-DDA (332) F +971 4 427 2449

dda.gov.ae

SR. NAME OF INSTITUTION LOCATION POSITIONPERIOD

FROM TO

EXPERIENCE:

Notes: - DDA Zoning Division shall bear no liability in registration of “HSE Officer” for genuinity of the attested educational certificates.- Requestor (HSE Officer) shall bear the full liability incase of forged educational certificates.

NAME

MOBILE

E-MAIL

DATE

SIGNATURE

STAMP

HSE OFFICER DETAILS

NAME

MOBILE

E-MAIL

DATE

SIGNATURE

STAMP

CONTRACTOR DETAILS

ZA-DC-F-34 Issue 7, Rev 1, Dated 18/12/2018 Page 2 of 2

PO Box 478844, Dubai, UAET +971 800-4-DDA (332) F +971 4 427 2449

dda.gov.ae