Pensioner Rebate

NOOSA COUNCIL
Application for rate concession
Queensland government pensioner rate subsidy scheme and council pensioner concession policy


4. Consent of applicant/s

I/we                                                          , authorise:
• The Noosa Shire Council to use Centrelink Confirmation eServices to perform a Centrelink/Department of Veteran Affairs
  (DVA) enquiry of my Centrelink or DVA Customer details and concession card status in order to enable the business to
  determine if I qualify for a concession, rebate or service.
• The Australian Government Department of Services (the department) to provide the results of that enquiry to Noosa Shire
  Council.
I understand that:
• The department will use information I have provided to the Noosa Shire Council to confirm my eligibility for pensioner
  concessions/rebates and will disclose to the Noosa Shire Council personal information including my name, address,
  payment and concession card type and status.
• This consent, once signed, remains valid while I am a customer of Noosa Shire Council unless I withdraw it by contacting
  Noosa Shire Council or the department.
• I can obtain proof of my circumstances /details from the department and provide it to Noosa Shire Council so that my
  eligibility for pension concessions/rebates 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
  Pension Concession/Rebate provided by Noosa Shire Council.


Signature                                                      Signature


Date                                                           Date
This consent will be used for the sole purpose of authorising Centrelink to provide information to Noosa Shire Council to
assess your eligibility in relation to concessions or services provided by the Queensland State Government and Noosa
Shire Council.




Privacy
Noosa Shire Council will only use the personal information collected for the intended purpose, to remain in contact with
you regarding your request and the legitimate functions and services of Council affecting your property. Council is
authorised to collect this information in accordance with the Local Government Act 2009 and associated laws. Access to
your personal information will only be provided to appropriate Council employees and authorised officers. Your personal
information will only be disclosed to third parties with your consent, or if required to do so by law. Your personal
information is handled in accordance with Council’s Privacy Policy.

 NOOSA COUNCIL                  PO Box 141              P. (07) 5329 6500         [email protected]
 ABN 97 969 214 121             TEWANTIN QLD 4565       F. (07) 5329 6501         www.noosa.qld.gov.au