Applicant Declaration and Authorisation

      I confirm:

• all particulars provided on this application form are to the best of my knowledge true and correct.

      I authorise:

• the Department of Planning, Industry and Environment (the Department) to use Centrelink Confirmation eServices to perform a Centrelink enquiry of my Centrelink customer details and concession card status to enable the Department to determine if I qualify for a concession, rebate or service.
• Services Australia to provide the results of that enquiry to the Department.

       I understand that:

• it is my responsibility to notify the Department of any changes to this information.
• Services Australia will use information I have provided to the Department to confirm my eligibility for NSW energy rebates and will disclose to the Department personal information including my name/address/payment type/payment status and concession card type and status.
• this consent, once signed, remains valid while I am a customer of the Department unless I withdraw it by contacting the Department or the Services Australia.
• I can get proof of my circumstances/details from the Services Australia and provide it to the Department so my eligibility for NSW energy rebates can be determined.
• if I withdraw my consent or alternatively do not provide proof of my circumstances/details, I may not be eligible for the NSW energy rebate provided by the Department.

Eligibility Criteria

To be eligible for the Family Energy Rebate in a given financial year the applicant must:

• be a resident in New South Wales; AND
• be an account holder of an electricity retailer, or a long term resident of an on-supplied residential community, or a resident of an on-supplied retirement village, or a resident of an on-supplied strata scheme; and whose name appears on the electricity account for supply to his or her principal place of residence; AND
• have been assessed by the Australian Government Department of Human Services (Services Australia) as being eligible for the Family Tax Benefit (FTB) A or B for the previous financial year and have received a payment of FTB in respect of that eligibility; AND
• have reconciled your taxes with Services Australia for 2019/20.

Note: If you have a Centrelink Concession Card or Health Care Card, and meet all the eligibility criteria for the Family Energy Rebate, your rebate credit will be approved at the lower capped rate of $20 ($22) as you will also qualify for the Low Income Household Rebate. For information on the Low income Household Rebate go to our webpage at: https://energysaver.nsw.gov.au/households/rebates-and-discounts.

Privacy Policy

The personal information you provide in the application form is subject to the Privacy and Personal Information Protection Act 1998. It is being collected by the Department for purposes related to processing your application for an energy rebate and auditing the rebate program which may include surveying customer experiences. The Department will not disclose your personal information to anybody else unless authorised by law. Further information can be obtained from the Department website at www.dpie.nsw.gov.au.

If you do not have an email address please complete a paper application form.

If the name of your electricity retailer does not appear in the drop down list please complete a paper application form.

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