KD-SYS-AA-019 · Appointments, competence and audit

Authorised Person Appointment Certificate — fillable PDF

2 pages. 74 fields. Fillable in Adobe Reader, Preview, Chrome, or on a phone.

Named appointment, scope, limits and expiry for every authorising role in the permit system.

The legal basis, cited on the form

HSE HSG250 (identification of who may authorise particular jobs and the limits of their authority)

What it is not

It is not a completed document and it is not health and safety advice. You must adapt it to your site and have a competent person complete and issue it. See why we don't say "compliant".

Format

AcroForm fillable PDF. Every field has a tooltip. Tab order follows the reading order. Works on desktop and mobile, in Adobe and non-Adobe readers.

This revision was prepared against legislation current at 2026-08-07. Revision R01.0. Check kubitdocs.com/revisions for the current revision before use.

Not yet on sale. This document is in technical review. It goes on sale only once a named, qualified reviewer has signed a Certificate of Technical Review for this revision.