Transcription of Carers Registration Concession Declaration
1 UNCLASSIFIED SENSITIVE: PERSONALC arers Registration Concession DeclarationPage 1 of 1On 9 August 2010, an increase in vehicle tax was introduced for cars, buses, trucks and plant vehicles between 976 kg and 2504 kg tare weight. Registered operators who are Commonwealth Carer allowance recipients are eligible for a Concession on this increase for one vehicle at a time. For joint registered vehicles, both operators must be Commonwealth Carer allowance recipients. If you are not already exempt from paying vehicle tax ( you hold a Pensioner Concession Card) and you are a Commonwealth Carer allowance recipient, you may be eligible for a refund of the additional vehicle tax. If you believe you are eligible for this Concession , you should complete and sign the Declaration . This Declaration gives your consent for Transport for NSW to validate your personal information with Services Australia - 13 22 Applicant(s) detailsSurnameGiven namesNSW Transport for NSW Customer no.
2 / Licence of birth//DayMonthYearCentrelink Customer Reference no. (CRN)2. Vehicle detailsNSW Plate numberVIN / Chassis number3. DeclarationApplicant signatureDatedaymonthyear//Government Rebates & Refunds, Transport for NSW Locked Bag 14, Dubbo NSW 2830 Mail it to :a Service NSW Centre (it will be forwarded to the Government Rebates & Refunds Office, Dubbo for processing)Take it to :Please return this completed form:SurnameGiven namesNSW Transport for NSW Customer no. / Licence of birth//DayMonthYearCentrelink Customer Reference no. (CRN)Catalogue no. 45071544 Form No. 1568 (05/2021)Second applicant (for joint registered vehicles only)I am a Commonwealth Carer allowance recipient. I authorise Transport for NSW to confirm with Centrelink details about my carer benefit entitlement. This includes whether or not the details I have provided Transport for NSW match Centrelink records and whether or not I am still receiving a Centrelink benefit.
3 I agree, unless I revoke my consent, this Customer Consent is a permanent consent, and may be relied on until such time as I revoke it. I may revoke my consent at any time by giving Transport for NSW written notice. I understand if I revoke my consent, I will not be eligible for the carer exemption provided by Transport for NSW. You declare that the information on this form is true and applicant signature (if applicable)Datedaymonthyear//Fax it to :(02) 6841 4816orEmail it to Collection Notice Transport for NSW is committed to protecting your privacy and ensuring your personal and health information is managed according to law. Find out why we collect your personal information, including how we use and manage it, by reading our privacy statement at or phone 13 22 13 to request a copy.
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