Transcription of Accommodation Supplement Application form S01
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Accommodation Supplement Application form S01
Page 1 S01 APR 2020 Write your Client number here. It can be found on your Community Services Card or SuperGold number Tell us your detailsWhat is your full name?First and middle namesSurname or family nameWhat date were you born?DayMonthYearTell us how we can contact youHOW TO ANSWER Q3:If you live in a rural area, flat/house number could include your RAPID number, fire number, emergency services TO ANSWER Q4:Mailing address can include a PO Box, rural delivery details, or C/O TO ANSWER Q5:Please only give uscontact details you d like us to do you live?Flat/House numberStreet nameSuburbTown/CityIs your mailing address different from where you live?NoYe sTell us your mailing addressHow else can we contact you? Tick the best way for us to first contact youHome phone( )Mobile phone( )Other phone( )EmailTell us who you live withDo you live alone?
Boat, caravan or motorhome No Yes Other No Yes ATTACHMENT FOR Q10: You may be asked to ... In this application form, ‘partner’ means the person you are married to or in a civil union …
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