Reference Document - Bushfire attack level assessment repor (As Published)t · MCU25/0022

                                       BUSHFIRE SURVIVAL PLAN
        Complete your personalised Bushfire Survival Plan lift-out.


        Personal details:
        Important phone numbers: 000 (Fire, Police and Ambulance)

        Family:                              Family:                                      Family:

        Work:                                Friends:                                     Friends:

        School:




        Important contact details – name and phone number:
        Insurer:                             Policy Number:                               Phone:

        Electricity: 		                                                                   Phone:

        Water: 		                                                                         Phone:

        Gas: 		                                                                           Phone:

        Phone Company: 		                                                                 Phone:

        Council:                             Phone:




        Leave early:
        List all names and contact phone numbers of household members who have decided to leave early then complete
        Section 1.

        Names:



        Phone:




        Stay:
        List all names and contact phone numbers of household members who have decided to stay, then complete Section 2.

        Names:



        Phone:




        10                                                                                    PREPARE ACT SURVIVE
                                                                                                                    

Document Set ID: 24478325
                  23591412
Version: 1, Version Date: 19/01/2026
                          28/02/2025