• Customer Consent Script

  • This Consent will be used for the sole purpose of authorising Centrelink to provide George Town Neighbourhood House access to assess your eligibility in relation to concessions or services provided by The George Town Neighbourhood House.

     

    Income Confirmation

  • I authorise:

    The George Town Neighbourhood House to use Centrelink confirmation eservices to perform a Centrelink enquiry of my customer details and concession card status in order to enable the business to determine if I qualify for a concession rebate or service.

    The Australian Government Department of Human Resources (The Department) to provide the results of that enquiry to The George Town Neighbourhood House.

    I Understand:

    The Department will disclose personal information to The George Town Neighbourhood House including my payment type/payment status/one off payment/income/assets/deductions/shared care arrangements/partner status to confirm my eligibility for relevant concession/rebate/service.

    This Consent, once signed remains valid while I am a customer of The George Town Neighbourhood House unless I withdraw it by contacting the George Town Neighbourhood House or The Department.

    I can get proof of my circumstances/details from the department and provide it to the George Town Neighbourhood House so that my eligibility for relevant concession/rebate/service can be determined.

    If I withdraw my consent or do not alternatively provide proof of my circumstances/details, I may not be eligible for the concession/rebate/service provided by The George Town Neighbourhood House

    Applicant:
    CRN:
    Date of Birth:
    Todays date:

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