Application for an Additional Occupant – Web Form

This form is to be completed by a tenant of Link Wentworth to apply for additional people to join their household. The questions that we need evidence for are marked on the form. Information about the type of evidence we need is in the Evidence Requirements Information Sheet.

For information or assistance with this form, please contact us on 13 14 21 or call into one of our offices. If you need more room to answer any questions, please include details on a separate page and attach it to this form.

If you are applying for more than one household member, please complete one form for each person you are adding to the household.

If you would prefer to print this form, a PDF version is available here – Application for an Additional Occupant.
You can submit this form and required evidence to your nearest Link Wentworth office or email a copy to enquiries@linkwentworth.org,au

"*" indicates required fields

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Tenant Information

Name

Last name or family name Given name(s)

Tenancy Address

Tenancy Address

Phone

Phone number

Phone

Phone number

Additional occupant information

This section is to be completed by the Tenant. Please include the details of each new additional occupant to be housed with you. Attach proof of identity for each additional occupant in your household. You will also need to attach proof of citizenship, residency or visa category, property ownership, income and assets for each additional person 18 years old or over. See the Evidence Requirements Information Sheet for more information.

How many new additional occupants do you want to add? Please note you will need to submit this form for each additional occupant.

12345

Additional Occupant Details

Full name

Title

MrMrsMissMs

Sex

MF

Date of Birth

DD slash MM slash YYYY

Relationship to you

Customer Reference Number (CRN)

Date when moving into property

DD slash MM slash YYYY

Do they earn income other than Centrelink? If yes, please provide details and evidence.

Yes

No

Please provide details and evidence. You can either provide copies of past Centrelink statements or sign an Income Consent Form so staff can access statements on your behalf. Please speak to a staff member for more information.

Is the additional occupant born in Australia?

Yes

No

Country of Birth

Country of Birth

Main language spoken at home

Main language spoken at home

Is the additional occupant an Australian Citizen?

If the additional occupant is not an Australian citizen, what is its residency status and their visa subclass number? (Write the relevant residency status then write the visa subclass number)

Yes

No

Residency status

Visa subclass number

Date of arrival

DD slash MM slash YYYY

Is this additional occupant currently living at your property?

Yes

No

What date did they move in?

DD slash MM slash YYYY

What is their current address?

Does this additional occupant have a current application for housing?*

Yes

No

T-file number or Client reference number

Does the occupant wish to remain on the NSW housing register? If no, the additional occupant should provide a written request to remove them from the register*

Yes

No

Is this additional occupant a current tenant, an additional occupant or a former tenant of Link Wentworth or Housing NSW?*

Yes

No

Aboriginal or Torres Strait Islander Origin

Are you, or the additional occupant, of Aboriginal or Torres Strait Islander origin?

No

Aboriginal

Torres Strait Islander

If not already provided, attach confirmation of Aboriginality. See the Evidence Requirements Information Sheet for details.

Do you or anyone on this application have a disability or ongoing medical condition?

Yes

No

Disability or medical condition

Attach proof of disability or medical condition. See the Evidence Requirements Information Sheet for details.

Proof of disability or medical condition

Drop files here or Select files

Accepted file types: jpg, gif, png, pdf, Max. file size: 15 MB.

Support arrangements

Do you or a person on this application receive ongoing support from an organisation, a program or a person/individual?

Yes

No

Name of organisation or program providing support

(if relevant)

Name of support worker or person/ individual

Contact phone number

Does the additional occupant have child custody arrangements in place/is the additional occupant a child due to custody?

Yes

No

If yes, please provide details

Attach documents that support your answer.

Mandatory evidence required:

• Proof of Identity
• Proof of NSW residency
• Evidence of Australian citizenship or residency status/visa category
• Proof of income

Supplemental evidence:

• Proof of disability/medical condition (if applicable)
• Proof of supports in place (if applicable)
• Proof of recognition of Aboriginal or Torres Strait Islander descent (if applicable)
• Proof of child custody arrangements (if applicable)

Attach evidence

Drop files here or Select files

Accepted file types: jpg, gif, png, pdf, Max. file size: 15 MB.

Signature – I declare that the above details are correct.

Date of arrival

DD slash MM slash YYYY

What date did they move in?

DD slash MM slash YYYY

T-file number or Client reference number

Please see Evidence Requirements Sheet for further details. Link Wentworth collects personal information about you in order to make sure you receive the assistance you may be entitled to.