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ESSENTIAL TRAVELLER - RECORD OF CLOSE CONTACT*These records must be retained and if requested, be produced to an Authorised Officer
as proof of compliance with Directions issued pursuant to the Emergency Management Act, 2004.
Name of Close Contact Phone Number Date / Time Location of Close Contact
This form can be downloaded at www.sa.gov.au V1 as at 9/05/2020
ESSENTIAL TRAVELLER - RECORD OF CLOSE CONTACT*These records must be retained and if requested, be produced to an Authorised Officer
as proof of compliance with Directions issued pursuant to the Emergency Management Act, 2004.
Name of Close Contact Phone Number Date / Time Location of Close Contact
This form can be downloaded at www.sa.gov.au V1 as at 9/05/2020
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