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Bali and Jakarta bombing - Australian Survivors and Next of Kin

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Register your interest

This may include:
  • name at birth
  • name before marriage
  • previous married name
  • cultural name
  • alias
  • adoptive name
Where are you located?
Mobile phone number
Home phone number
Are you an injured survivor of the 2003 Marriott Jakarta Bombing?
Are you an injured survivor of the 2002 Bali Bombing?
Are you a bereaved Next of Kin of a victim/s of the 2002 Bali Bombings?
Your relationship to the Victim
Geographic location the Victim ordinarily resided in
Add additional Victim
Your relationship to the Victim
Geographic location the Victim ordinarily resided in
Were you previously a nominated Primary Point of contact for your family?
The family nominated Primary Point of Contact is the 'Primary Next of Kin' who previously received direct updates from AFP/DFAT.
Please include details here.

US Military Tribunal Updates

Do you wish to receive updates/information about the US Military Tribunal directly from the US DoD and Victim/Witness Assistance Program (VWAP)?
If you opt in to receive information about the US Military Tribunal proceedings directly from the Military Tribunal Victim/Witness Assistance Program, the AFP will provide the information collected in this form to the US DoD and the VWAP.
Do you wish to receive information from the DoD and VWAP about attending or viewing the proceedings, opt in to receiving information and updates from DoD and VWAP.
The DoD has advised the AFP that Australian survivors and victims' NoK may be able to attend the tribunal hearings in Guantanamo Bay or view live-stream proceedings from a dedicated US location. The DoD has advised that it will not be possible to view live streaming of proceedings in Australia.

Potential Australian witnesses

Do you wish to be considered to give evidence in the US Military Tribunal as a witness (survivor or NoK of a victim)?
US authorities also wish to identify potential Australian witnesses (survivors and bereaved NoK of victims) to give evidence before the Tribunal. You may register your interest in being a witness in the proceedings. Your registration of interest in being a witness will be considered by the FBI together with DoD and VWAP and you may be contacted by these agencies. Registration of interest will not result in automatic selection as a witness.

If you indicate you wish to be considered to give evidence as a witness in the US Military Tribunal, the AFP will provide the information collected in this form to the FBI, which is coordinating contact with witnesses for the proceedings.  We understand this information will be provided by the FBI to the US DoD and the VWAP.

Contact with Australian government agencies 

Do you wish to be included in the AFP - Email Distribution List to receive updates from the AFP in the future?
If you wish to receive information from the AFP in relation to the US proceedings and other issues that may be of interest to survivors and NoK of victims, please opt in to receiving information from the AFP
Do you wish to register your details with DFAT for future contact?
The AFP is also taking the opportunity to ask whether survivors and NoK wish to provide their details to the Department of Foreign Affairs and Trade (DFAT) for the purposes of future contact.

Confidentiality of your information

Your personal information will only be used and disclosed for the purposes to which you agree or as otherwise authorised under the Privacy Act 1988 (Cth).  For further information about how the AFP handles personal information, please see our Privacy page, which contains a link to our Privacy Policy, and information about how you can access or correct your personal information or make a privacy complaint.

Any personal information provided by the AFP to the US agencies referred to above will be actioned through secure means. US Government Departments are subject to similar privacy laws as Australian Government agencies and will not use or disclose information other than the purposes for which it was provided to them or as authorised by US law.  

I confirm that any other family members (living) I have referenced in the form (if relevant), have consented to having their personal information collected, used and disclosed for the purposes set out in this form.

Thank you for taking the time to register your details and interest. We will review your responses and be email contact with you, noting your preferred interest and registration in this form.
 
If you are experiencing distress/mental health concerns, please get in touch with Beyond Blue (Call 1300 22 4636) or Lifeline (Call 13 11 14) to speak with a trained mental health professional (24 hours 7 days a week).

We will treat this information in accordance with our obligations under the Privacy Act 1988 (Cth).
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