1. Step 1 Your Details
  2. Step 2 Financial Dependants
  3. Step 3 Financial Hardship
  4. Step 4 Choose an Option
  5. Step 5 NET amount
  6. Step 6 Value of Assets
  7. Step 7 Weekly Income
  8. Step 8 Weekly Expenses
  9. Step 9 CRN
  10. Step 10 Arrears and Liabilities
  11. Step 11 Payment Details
  12. Finish Download and post
Step 1

Your details

Step 1 of 11

Your details

Title
Choose a title from the options
Your given names are required (Maximum 28 characters).
Your surname is required (Maximum 28 characters).
Date of birth
Your birthdate is required

Residential Address

Your street address should be less than 28 characters.
Your town/suburb is required (Maximum 19 characters).
Required
4 digits required
Postal Address same as Residential Address
Please specify whether your employer will make contributions

Postal Address

Your street address should be less than 28 characters.
Postal suburb/town is required (Maximum 19 characters).
Required
4 digits required
Please use 10-digit format, no spaces, eg 0290009999.
Please use 10-digit format, no spaces, eg 0490009999.
Please provide a valid email address (Maximum 28 characters).
Your member number is required (9 digits)
10 or more digits in your member number? Simply enter the final 9 numbers above.

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