Application for a Rent Subsidy

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Step 1 of 5

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Section 1: Tenant Information

Given Name(s)(Required)

Surname(Required)

Tenancy Address(Required)

Street Address Address Line 2 City State Post Code Country

Tenant ID(Required)

Email(Required)

Phone Number(Required)

Section 2: Household Information

All household members are to be listed including children

Household Member #1

Full Name

DOB

DD slash MM slash YYYY

Gender

Relationship to tenant (you)

Main income type

Centrelink Reference number (CRN)

Centrelink Authority provided

Yes

Is the information listed correct?

Yes

Household Member #2

Full Name

DOB

DD slash MM slash YYYY

Gender

Relationship to tenant (you)

Main income type

Centrelink Reference number (CRN)

Centrelink Authority provided

Yes

Is the information listed correct?

Yes

Household Member #3

Full Name

DOB

DD slash MM slash YYYY

Gender

Relationship to tenant (you)

Main income type

Centrelink Reference number (CRN)

Centrelink Authority provided

Yes

Is the information listed correct?

Yes

Household Member #4

Full Name

DOB

DD slash MM slash YYYY

Gender

Relationship to tenant (you)

Main income type

Centrelink Reference number (CRN)

Centrelink Authority provided

Yes

Is the information listed correct?

Yes

Household Member #5

Full Name

DOB

DD slash MM slash YYYY

Gender

Relationship to tenant (you)

Main income type

Centrelink Reference number (CRN)

Centrelink Authority provided

Yes

Is the information listed correct?

Yes

Household Member #6

Full Name

DOB

DD slash MM slash YYYY

Gender

Relationship to tenant (you)

Main income type

Centrelink Reference number (CRN)

Centrelink Authority provided

Yes

Is the information listed correct?

Yes

Household Member #7

Full Name

DOB

DD slash MM slash YYYY

Gender

Relationship to tenant (you)

Main income type

Centrelink Reference number (CRN)

Centrelink Authority provided

Yes

Is the information listed correct?

Yes

Household Member #8

Full Name

DOB

DD slash MM slash YYYY

Gender

Relationship to tenant (you)

Main income type

Centrelink Reference number (CRN)

Centrelink Authority provided

Yes

Is the information listed correct?

Yes

Examples of income or asset evidence,

Centrelink payments – Current itemised Centrelink Income Statement unless you have given consent for us to get this information directly from Centrelink.
Veterans’ Affairs payments – Current itemised statement from the Department of Veterans’ Affairs
Wages – Wages and Salaries form (form C) completed by your employer, or 26 weeks’ worth of consecutive pay slips (we will accept a minimum 12 weeks’ worth of pay slips)
Business Income (self-employed) – Current profit/loss statement completed by an accountant or a copy of latest taxation return (not a notice of assessment).
Superannuation – Current letter from the Superannuation Fund confirming the amount received
Overseas/foreign Pension – Current letter from the respective government detailing the amount you receive.
Savings & Investments (including residential or commercial real estate) – Letter from all investment institution(s) detailing current balance(s).
Maintenance/Child Support – Current itemised Centrelink Income Statement or current Child Support statement from Services Australia.
No Income – 3 months’ worth of all bank statements for all accounts held to show no income is being received, along with a statutory declaration stating that no income is being received.

Section 3: Household Changes

Has there been changes to your household and/or household income since your last rent review?

No (Go to Section 5)

Yes (Continue below)

Has someone moved into or out of the property since your last rent review?

No (Go to Section 4)

Yes (Continue below)

Household Member #1

Full Name

DOB

DD slash MM slash YYYY

Gender

Relationship to tenant (you)

Moving in/out

Yes

Date moved in/out

DD slash MM slash YYYY

Income type (if moving in)

Household Member #1

Full Name

DOB

DD slash MM slash YYYY

Gender

Relationship to tenant (you)

Moving in/out

Yes

Date moved in/out

DD slash MM slash YYYY

Income type (if moving in)

Household Member #1

Full Name

DOB

DD slash MM slash YYYY

Gender

Relationship to tenant (you)

Moving in/out

Yes

Date moved in/out

DD slash MM slash YYYY

Income type (if moving in)

Please ensure that you submit all supporting income documents for anyone moving in, along with an Application for an Additional Occupant form with this application. Applications for Additional Occupants can be found on our website or can be provided by your local office. Please provide income details for all household members over 18.

If someone has moved out and you would like Link Wentworth to consider backdating your rent to the date they moved out, you will need to supply evidence that they no longer reside at your property, such as a lease document or utility bill. (A statutory declaration will not be accepted for backdating purposes)

Section 4: Income Changes

Question 1: Have you or someone in your household started or stopped working or had a wage change since your last rent review?

No (Go to Question 2)

Yes (List below)

Household Members

Full Name

Relationship to you

Change? (e.g. started or stopped work, wage reduction or increase)

Date of change

4 weeks of payslips available?

Payslips

Drop files here or

Max. file size: 10 MB.

Please provide a minimum of four (4) weeks’ worth of payslips from the date you started working for each member. If you do not have 4 weeks of payslips available, please submit this form and discuss with your Tenancy Manager or a Rent Subsidy Specialist.

Question 2: Have you or someone in your household recently started a business?

No (Go to Question 3)

Yes (List below)

Household Members

Full Name

Relationship to you

ABN

Date of change

Profit & Loss

Drop files here or

Max. file size: 10 MB.

Please provide a profit and loss statement prepared by an accountant for each member. For further information please contact a Link Wentworth staff member

Question 3: Have you or someone in your household had a change in income or Centrelink payment type not already listed above? For example, a payment change

No (Go to Section 5)

Yes (List below)

Household Members

Full Name

Relationship to you

Date of change

Details of change

Section 5: Declaration

I have understood the instructions given on this form. I declare that all the information I have given is true and correct to the best of my knowledge for every person.

Signature

26882

Forms

Application for a Rent Subsidy

Section 1: Tenant Information

Section 2: Household Information

Household Member #1

Household Member #2

Household Member #3

Household Member #4

Household Member #5

Household Member #6

Household Member #7

Household Member #8

Section 3: Household Changes

Household Member #1

Household Member #1

Household Member #1

Section 4: Income Changes

Section 5: Declaration

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