Application for Council Pensioner Concession Rates Rebate

If joint owners are eligible for a pensioner concession, a separate application form will need to be submitted by each owner to receive the maximum rebate, otherwise only a partial rebate will be granted.

Your Details

Property No.*

First Name*

Last Name*

Property Address*

Suburb*

State*

Postcode*

Phone Number*

Email Address*

Do you consent to Tamworth Regional Council updating their records with the information provided above?*

Concession Card Type*

Date of grant of Concession Card*

Concession Card Number*

Please upload a copy of your Concession Card*

Is the above property address your sole / principal place of living?*

Yes

When did you move into the property?*

Have you claimed a pensioner rebate for any other property in the last 12 months?*

Yes

Are you the sole owner of the property?*

Yes

Declaration

I declare that the information provided in this form is true and correct and that I am the person making this application. I understand that providing information that is false or misleading is an offence, the maximum penalty for which is 200 penalty units or 2 years imprisonment or both.

I have read and accepted the declaration and authority*

Privacy notice

When you submit this form, the information you provide on it is being collected and held by Tamworth Regional Council (Council), 474 Peel Street TAMWORTH NSW 2340, to assess your eligibility to receive a pensioner concession regarding the payment of charges and/or rates under the Local Government Act 1993 (NSW) (LG Act) and associated regulations.

The information provided on this form is private and confidential. Council will not disclose the information to any person or body if it is not directly related to the purpose for which the information was collected, unless disclosure is required under a relevant law. The supply of your information is voluntary, but if you choose not to provide information requested on this form and evidence that you meet the definition of an ‘eligible pensioner’ under the LG Act and associated regulations (see below), it may affect the outcome of your application for a pensioner concession.
If you would like more information on privacy, wish to correct or update your personal information provided, or have a complaint about the use of your personal information, contact Council’s Public Officer.

Consent to obtain evidence to assess your application for a pensioner concession

To assist Tamworth Regional Council with assessing your eligibility for a pensioner concession, it seeks your consent to use Centrelink Confirmation eServices to perform a Centrelink and/or Department of Veterans’ Affairs (DVA) enquiry, and obtain its results, regarding your Centrelink or DVA customer details and concession card status. Your details may be checked regularly, to confirm ongoing eligibility. At any time, you have a right to withdraw your consent by contacting Tamworth Regional Council or Services Australia.

Please read the following and then select a tick box below regarding your consent.

I authorise:

Tamworth Regional Council to use Centrelink Confirmation eServices to perform a Centrelink/DVA enquiry of my Centrelink or DVA customer details and concession card status to enable Tamworth Regional Council to determine if I qualify for a pensioner concession.
Services Australia to provide the results of that enquiry to Tamworth Regional Council.

I understand:

Services Australia will disclose my personal information to Tamworth Regional Council including my (name, address/postcode, concession card type and status) to confirm my eligibility for a pensioner concession.
If I withdraw my consent or do not alternatively provide proof of my circumstances or details, I may not be eligible for the pensioner concession provided by Tamworth Regional Council.
Tamworth Regional Council will disclose my personal information received from the result of the Centrelink/DVA enquiry to the Audit Office of New South Wales for the purposes of auditing/assurance.
This consent, once signed, remains valid while I am a customer of Tamworth Regional Council unless I withdraw it by contacting Tamworth Regional Council or Services Australia. I can get proof of my circumstances or details from Services Australia or DVA and provide it to Tamworth Regional Council so they, Tamworth Regional Council, can determine my eligibility for a pensioner concession.

Yes, I have read and understand the above and give my authorisation.*

No, I do not agree to the above and do not give my authorisation. Instead, I will provide a Proof of Concession Eligibility Letter from Centrelink or DVA.

Additional Information

Council will determine your eligibility to receive a pensioner concession of up to $250 off your annual rates and/or charges. 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 Council provides these services. Alternatively, if Council does not provide these services, contact your water/sewer service provider for more information.

Eligibility:

• Holders of the PCC (Pensioner Concession Card)*;

• Holders of the DVA Veteran Gold Card embossed ‘TPI’ (Totally & Permanently Incapacitated);

• Holders of the DVA Veteran Gold Card embossed ‘EDA’ (Extreme Disablement Adjustment).

Holders of cards other than those listed above are not eligible for the concession.

* If you are a War Widow or Widower or Wholly Dependent Partner and do not have a Pensioner Concession Card, you could contact the DVA to test your eligibility for the DVA Income Support Supplement which attracts a PCC. Eligibility is subject to an income and assets test. For assistance from the DVA call 1800 VETERAN (1800 838 372).

Privacy Statement

Personal information supplied to or collected by Tamworth Regional Council will only be stored and processed by Council for lawful purposes directly related to the functions and activities of Council. Any personal information supplied will only be disclosed to a third party for the purpose of performing a lawful function or activity and for no other purpose. Disclosure of personal information to a third party will be in accordance with Tamworth Regional Council's Privacy Management Plan (<~~DocAnnotation.type.271~~> <~~DocAnnotation.size.271~~>).

Mandatory field(s) marked with *