Online forms: Council Pensioner Concession Rates Rebate - Application Form

This form has 4 pages

Declaration and Authority

The information contained in this application form and any information requested for the purpose of assessing eligibility for a pensioner concession is required under the Local Government Act 1993 and the Local Government (General) Regulation 2005.

You have right to withdraw your consent by contacting your Council. The information is private and confidential and your Council must not disclose the information to any person or body, if it is not directly related to the purpose for which the information was collected. If you have a complaint about the use of your personal information, contact your Council’s Public Officer. The information contained or referred to in this application form may be corrected and updated by you, by contacting your Council.

To verify your eligibility for a rebate Council will need to confirm your concession card details with Centrelink or the Department of Veterans’ Affairs. Your details may be checked regularly, to confirm ongoing eligibility. Please acknowledge below to confirm your consent to your Council checking your concession eligibility with Centrelink or the Department of Veterans’ Affairs.

By submitting this form, I declare that the information provided is true and correct and I am the person making this application. If you make a false statement in an application, you may be guilty of an offence and fined up to $2,220.