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Fuel Drive-Off Form

If the incident is happening now please contact Triple Zero, 000.

Only use this on-line service if:

  • you do not have a current reporting arrangement with your local police.
  • you are the informant in this matter.
  • you have a valid and current business E-mail address.

Subject to operational requirements, you will receive a reply to your nominated e-mail address within 48 hours which will contain your Queensland Police reference number.


The Queensland Police Service collects information to assist in performing its statutory functions and responsibilities. Information provided will be used to process your application, create a Police Report, and/or resolve your complaint, compliment or query. You may be required to provide a personal identification number such as drivers licence or passport number to assist in verifying your identity. Your personal information will be managed in compliance with the Information Privacy Act 2009.

There is the provision on some Online Forms to opt-out of providing any personal information. In these instances, the QPS will not collect, store, or use any personal information, and the above stipulations do therefore not apply.

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    1. Agree   Disagree
As you have not agreed to the Privacy Statement, you cannot continue. As an alternative, please telephone Policelink on 131 444 or visit your local Police Station.

* indicates required fields
Fuel Driveoff Form Queensland Police Logo
  1. * Yes   No
  2. *
  3. Informant Details
    1. * Queensland Driver Licence / 18+ Card
      Australian Driver Licence / 18+ Card
      None of the above
    1. *
      • *
      • *
      • *
      • *
      • *
    2. If you cannot supply one of the numbers above, you cannot proceed with this form. Please contact Policelink on 131 444 or report the matter to your local police station.
    1. *
    2. *
    3. * Please use the following date format (DD/MM/YYYY).
    4. * Male   Female
    5. * example: console operator, Manager
    6. Your Address Details
    7. * example: 18 or 4/5 Smith Street
    8. *
    9. *
    10. *
      • *
  4. Service Station Details

    Note: Please provide the details of the Service Station which is responsible for the loss of the fare.

    1. * This information is found on the Business Certificate which is normally framed and displayed in the office, e.g. ABC Pty Ltd trading as ABC Service Station
    2. Address Details
    3. * example: 18 or 4/5 Smith Street
    4. *
    5. * A Queensland Police reference number will be e-mailed to this address.
    6. *
  5. Offence Details
    1. The date and times the suspect person/s has left without paying for the fare
      * Please use the following date format (DD/MM/YYYY).
    2. *
    3. *
    4. *
    5. *
      • *
    6. *
    7. * Yes   No
      • * Please use the following date format (DD/MM/YYYY).
      • * Yes   No
      • To assist Police with their enquiries please upload the photos. All photographs need to be either in a jpg, jpeg or png format and there is a limit of 5 photographs with the size of each file limited to 1MB. If you attempt to upload a photograph greater than 1MB or an incorrect file type, an error message will appear and the photograph(s) will need to be re-attached.

        If you have any trouble uploading the photographs upon receipt of your official Queensland Police reference number you can e-mail the photos to Please ensure to provide the reference number, your name, date of birth and address in the e-mail.

  6. Vehicle Details

    Note: To assist Queensland police with any enquiries, please describe the vehicle in as much detail as possible including its registration, if known.

    1. e.g. Toyota, Ford, Holden, Suzuki
    2. e.g. Corolla, Falcon, Commodore
    3. * e.g. a sedan with mag wheels and a damaged headlight.
  7. Suspect Person/s Details

    Note: To assist Queensland police with any enquiries, please provide a detailed description of the suspect.

    1. Male
    2. e.g. 20 years of age.
      e.g. mid to late 30s.
    3. e.g. The suspect had a grey goatee and a tattoo of a dragon on his left upper arm.
      e.g. The suspect had a scar on the right hand side of their face.
  8. Report Details
    1. * Yes   No
      • *
    2. * Yes   No
      • *
      • *
    3. *
    4. * Yes   No
      • *

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