Financial hardship or exceptional circumstances

I am requesting an application for financial hardship understanding that the following information will be used to consider my application:

• Previous payment history with council;
• The nature of the hardship (i.e. temporary or ongoing); and
• Independent financial counsellors written report for Hardship.

In some instances, such as low amount, long term, financial hardship payment plans, a team member may refer you to an independent financial counsellor. Some or all the following evidence may be requested by the counsellor to support your application. Please do not send this information to Council.

You may need to provide proof of:

• Wages - Previous and current payslips
• Expenses - Bank statement/tax assessments
• Employment - A letter confirming termination.
• Medical status – A letter confirming serious illness/accident /injury.
• Centrelink benefits - JobSeeker/low-income documentation and/or copies of Healthcare and Centrelink Pension cards.

I hereby acknowledge that I have read and comply with the privacy notice shown below. By submitting this agreement form I agree to the payment plan outlined above, that the information contained in this application is true and correct, and I understand that providing false evidence can lead to penalties.