energy concession form

Complete this form to update or add a concession to your energy account.

South Australian customers: Please click here to apply for a concession

your details (as per your concession card)

apply for all accounts

* account number

* first name

* last name

contact details

* email address

* phone number

address

* Is this your principal address?

Yes

concession card details

* card issuer

card type

* card number

* card start date

* card end date

* I authorise

amaysim Energy to use Centrelink Confirmation eServices to perform a Centrelink/DVA enquiry of my Centrelink or Department of Veterans’ Affairs Customer details and concession card status in order to enable the business to determine if I qualify for a concession, rebate or service.

* I authorise

The Australian Government Department of Human Services, DHS, to provide the results of that enquiry to amaysim Energy.

* I understand

DHS will use information I have provided to amaysim Energy to confirm my eligibility for the relevant concession or rebate and will disclose to amaysim Energy personal information including my name, address, payment and concession card type and status.

* I understand

This consent, once signed, remains valid while I am a customer of amaysim Energy unless I withdraw it by contacting amaysim Energy or DHS.

* I understand

I can obtain proof of my circumstances/details from the department and provide it to amaysim Energy so that my eligibility for the relevant concession or rebate can be determined.

* I understand

If I withdraw my consent or do not alternatively provide proof of my circumstances/details, I may not be eligible for the concession or rebate provided by amaysim Energy.