Application for Financial Hardship

To assist with the assessment process, please attach documentary evidence to assist us to review and assess your hardship application. Please include the following:

• A copy of all household bank accounts for the past three months
• Tax return statments and PAYG Summaries from the last two years
• Centrelink income statement no more than 30 days old (if applicable)
• Child Support Agency Statement no more than 6 months old (if applicable)

You may also include one or more of the following to further support your application:

• Statutory Declaration from someone familiar with your circumstance (eg. family doctor, accountant, bank officer, welfare officer, government agency)
• Medical certificates or other evidence demonstrating the circumstances that have resulted in financial hardship being experienced
• Evidence of loss of the main source(s) of income (eg. seperation certificate)
• Evidence of qualifying for Federal Government funding assistance in response to COVID-19
• Documented evidence of having sought financial counselling
• Other documentation demonstrating that you are experiencing financial hardship

Council reserves the ability to request further supporting information, at any time, if deemed necessary in order to assess your application.

Privacy Statement Your personal information is held by us in accordance with the Personal Information Protection Act 2004. The Personal Information Protection Act 2004 provides that an individual may request access to, or amendment of, information held by a public authority about that individual. Council’s Privacy Policy can be found at: www.ccc.tas.gov.au/your-council/laws-governance/privacy. If you cannot find the information that you are seeking or you wish to access your personal information, please contact us on 03 6217 9500 or email us at clarence@ccc.tas.gov.au.