Application for the NSW Government’s Family Energy Rebate Authorisation and Declaration

  • I confirm all particulars provided on this application form are to the best of my knowledge true and correct.

  • I authorise:
  • the Department of Planning, Industry and Environment (the Department) to use Centrelink Confirmation eServices to perform a Centrelink enquiry of my Centrelink customer details and concession card status to enable the Department to determine if I qualify for a concession, rebate or service.
  • DHS to provide the results of that enquiry to the Department.

  • I understand that:
  • it is my responsibility to notify the Department of any changes to this information.
  • DHS will use information I have provided to the Department to confirm my eligibility for NSW energy rebates and will disclose to the Department personal information including my name/address/payment type/payment status and concession card type and status.
  • this consent, once signed, remains valid while I am a customer of the Department unless I withdraw it by contacting the Department or the DHS.
  • I can get proof of my circumstances/details from the DHS and provide it to the Department so my eligibility for NSW energy rebates can be determined.
  • if I withdraw my consent or alternatively do not provide proof of my circumstances/details, I may not be eligible for the NSW energy rebate provided by the Department.


To be eligible for the Family Energy Rebate in a given financial year the applicant must:

  1. be a resident in New South Wales; AND
  2. be an account holder of an electricity retailer, or a long term resident of an on-supplied residential community, or a resident of an on-supplied retirement village, or a resident of an on-supplied strata scheme; and whose name appears on the electricity account for supply to his or her principal place of residence; AND
  3. have been assessed by the Australian Government Department of Human Services (DHS) as being eligible for the Family Tax Benefit (FTB) A or B for the previous financial year and have received a payment of FTB in respect of that eligibility; AND
  4. have reconciled your taxes with DHS for 2018/19.
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