20 you and/or your Pi Someone else? No[) Go to 52 Yes) 60 tornert question arin St share the care of your children ST Has the c: 18s the care arrange Since you lat told en! Shen in your car ehangod Nol> i i ue pea parinars ‘care arrangements ou Ge, OU wil need to contact ust upaete Go to next question ‘You and/or your partner wil need 7] ooomplete and return a Details of your child's come ‘arrangement (FAQ12) form. yeu donot hav ths frm, go to ‘Servicesaustralia.gov.au/forms Yes >. 60 to next question Checklist | | | 53. You and your partner need to rea this Privacy notice Privcy and your persona infomation The privacy and security of our personal information 'simportnt ous, ond is prtetes by la We collect thisintomation so we can process and manage your | 2ppleatons and payments, and provide serves fo you, | Wr oly share your ration wt ter parts where you havo aioe, oewhore ha aw allows or requires For more | iMrmaton, ooo seresaunrala gov au/privacy Declaration 54 We declare thet: ‘=the information we have provided inthis form is complete and corect. We understand that: + if submiting this form as part of a cam, the cleim may not be accord, unless supporting documents ar lodged at the same ime asthe claim. The only exception wil be if we are waiting for medical evidence or oler documents from a third par ; ‘52 Which ofthe folowing forms and documents are you andr your See a the rome seon? | | + ing feo misleading Information sa sarious efence, ‘Where you are asked to supply documents, provide original documents. n some circumstances, copies may be accepted You signature a detalied inthe below checklist. ityou are not sure, check the question to see you shoul é provide the documents , j = $ a Income and Assets (Mod i) form | (ied at quston 2 G] | sweoowtuvin | 29 |[ oa] ee 24 | Jou anower Yes el msBon2) Your parinors signature Payelps ora eter from your and/or your partner's || ‘employer confirming income for the last 8 weeks Gt you answered question 25) va ene DVA steer sina chal Oo 1 Details of income stream product ($4330) form aoe you answored Yes at question 20) ‘ 9 |2.8102) 2024 Orginal Notice of Assessment ori you are notrequred |) to lodgo a tax retun other documents to very the ae cee amount provided EBS eee fe lt required at question 314) Check that you have done the folowing ; * answered all the question that you need to patederinedte tee te (| * provided all requested information and any additional forms. ‘amount/s provided Hn pee ‘does not have a tax file number, go to gov. or more information. ef reqared at questions 215 Sa 2) ‘you and your partner have signed and dated this form. Payment summary eee ne ee TE a a (tf required at question 31D) Payment summary and/or income tax return or if you ‘ot required to lodge an income tax return, othor cuments to verify this amount quired at question 31E) sments to support the reason your income will be at question 34) of yur eis xr aregenet FTE om |) red Yes at question 51) Returning this form Return this form and any supporting documents: * online using your Centrelink online account. For Information, go to fo Servicesaustralia.gov.au/centrelinkuploaddocs. = by post to Centreink PO Box 7802 CANBERRA BC ACT 2610 + inperson at one of our service centres. 14 0f14