Pensioner Concession Application Form - Online

If you are not the sole owner, who else owns a share?

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 Council. The information is private and confidential and 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 Council’s Public Officer. The information contained or referred to in this application form may be corrected and updated by you, by contacting Council.

I authorise:

Camden Council to use Centrelink Confirmation eServices to perform a Centrelink/DVA enquiry of my Centrelink or Department of Veterans’ Affairs customer details and concession card status to enable Council to determine if I qualify for a concession, rebate or service.

The Australian Government Department of Human Services (the department) to provide the results of that enquiry to Camden Council.

I understand that:

The department will disclose personal information to Camden Council including my name/address/ payment type/payment status and concession card type status to confirm my eligibility for a pensioner concession.

This consent, once signed, remains valid while I am a customer of Camden Council unless I withdraw it by contacting them or the department.

I can get proof of my circumstances/details from the department and provide it to Camden Council so my eligibility for the pensioner concession 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 pensioner concession provided by Camden Council.

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 $nbsp;.

Additional Information

 

Council will determine your eligibility to receive a rebate of up to $250.00 on your rates account. You may also be eligible to receive up to $87.50 on your annual water charges and up to $87.50 off your annual sewerage charges, if they are provided by your local Council.

Eligibility:

• Holders of the PCC (Pensioner Concession Card);
• Holders of a gold card embossed with ‘TPI’ (Totally Permanently Incapacitated);
• Holders of a gold card embossed with ‘EDA’ (Extreme Disablement Adjustment);
• War widow or widower or wholly dependent partner entitled to the Pensioner Concession
Card*.

* If you are a war widow or widower or wholly dependent partner but do not have a Pensioner Concession Card, you should contact the Department of Veterans’ Affairs (DVA) to test your eligibility for the DVA income support supplement. Eligibility is subject to an income and assets test. Holders of cards other than those listed above are not eligible for the concession. For assistance from the DVA call 133 254.