Application for concession

ActewAGL is required to verify your concession card details with Services Australia. By ticking the checkbox below, you are authorising ActewAGL to make the necessary enquiries to confirm your eligibility for a concession or rebate.

I authorise:

• ActewAGL to use Centrelink Confirmation eServices to perform a Centrelink enquiry of my customer details and concession card status to determine if I qualify for a concession or rebate.
• Services Australia to provide the results of that enquiry to ActewAGL.

I understand that:

• Services Australia will disclose personal information to ActewAGL including my name and concession card status to confirm my eligibility for the concession or rebate.
• this consent, once signed, remains valid while I am a customer of ActewAGL unless I withdraw it by contacting ActewAGL or Services Australia.
• I can get proof, if required, of my circumstances from Services Australia and provide it to ActewAGL so my eligibility for the concession or rebate can be determined.
• if I withdraw my consent or don’t provide proof, if required, of my circumstances, I may not be eligible for the concession or rebate provided by ActewAGL.
• I am required to notify ActewAGL of any changes in my circumstances that would affect my continued eligibility for the concession or rebate.

I confirm that the electronic signature in this consent represents my signature.
I consent to signing the form electronically and confirm that my signature is legally binding.