Complete this form to update or add a concession to your energy account.South Australian customers: Please click here to apply for a concessionNew South Wales OnlyIf you're eligible for the Low-Income Household Rebate and have a gas account with amaysim, you'll automatically receive the NSW Gas Rebate.If you're eligible for the NSW Gas Rebate and have an electricity account with amaysim, you'll automatically receive the Low-Income Household Rebate.your details (as per your concession card) apply for all accounts * account number * name * first name * last name contact details* email address * phone number * address address * Is this your principal address? Yes No concession card details card issuer - None -CentrelinkDepartment of Veteran Affairs (DVA)Queensland GovernmentDepartment of Immigration and Border Protection (QLD Only)Services Australia (South Australia Only) card type - Select -Pensioner Concession Card (issued by Centrelink)Health Care Card (issued by Centrelink) card type - Select -Pensioner Concession Card (issued by the Department of Veterans' Affairs)DVA Gold Card (War Widow/er)DVA Gold Card (Extreme Disablement Adjustment)DVA Gold Card (Military Rehabilitation) (South Australia Only) card type - Select -Queensland Seniors Card card type - Select -ImmiCard for Asylum Seekers (QLD only) card type - Select -Commonwealth Seniors Health Care Card (South Australia Only)* card number * card start date * card end date I authorise The use of 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 amaysim Energy 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 in writing or the 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 refuse to give, or withdraw my consent or do not alternatively provide proof of my circumstances/details, I may not be eligible for the concession, rebate, or service.* I understand I must advise amaysim Energy if my circumstances change and I am no longer eligible to receive a concession.