Authorisation form for Income Confirmation


I authorise:

  • Women’s Property Initiatives to use Centrelink Confirmation eServices to perform a Centrelink/DVA enquiry of my Centrelink income, asset and payment details to enable the organisation to determine if I qualify for a service.
  •  the agency to provide the results of that enquiry to Women’s Property Initiatives.

I understand:

  • the agency will use information I have provided to Women’s Property Initiatives (WPI) to confirm my eligibility for relevant rebate/service and will disclose to WPI personal information including my name, address, concession card status, payment type, payment status, income, assets, one-off payment, deduction and shared care arrangements.
  • I can obtain proof of my circumstances/details from the agency and provide it to WPI so that my eligibility for relevant 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 rebate/service provided by Women’s Property Initiatives.
  • this consent, once signed, is effective for the service/s indicated, and only for the period that I am a customer of Women’s Property Initiatives.
  • this consent which is ongoing, may be withdrawn by me, at any time, by giving notice in writing to Women’s Property Initiatives.
  • Women’s Property Initiatives will maintain a record of my consent for 2 years from the date Women’s Property Initiatives ceases to provide the service.
  • I will be able to obtain a written copy of the income statements the agency provides to my housing organisation at any time from either the agency or Women’s Property Initiatives.