Medical Aids Subsidy Scheme, Queensland HealthProxy Access to Centrelink Information Form for MASS 84 This form is used for applicants to provide consent to MASS staff to access Centrelink concession.
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How to fill out the Centrelink Proxy Form online
Filling out the Centrelink Proxy Form online can streamline the process of granting access to your Centrelink concession card information. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to complete the Centrelink Proxy Form online.
- Press the ‘Get Form’ button to access the Centrelink Proxy Form and open it in your chosen digital editor.
- Begin by selecting the Concession Card Provider by ticking the appropriate box for either Centrelink or the Department of Veterans’ Affairs.
- Enter the Type of Concession Card you hold, such as Health Care Card, in the designated field.
- Input your Applicant’s Concession Card Number in the next field accurately as shown on your card.
- Fill in the Name of the Card Holder as it appears on the concession card.
- Complete the Address on Card field with the address listed on the concession card.
- If applicable, provide the Issue Date on Card by entering the date the card was issued.
- If relevant, fill in the Expiry Date on Card corresponding to your concession card.
- In the Applicant Confirmation section, write your name in the space provided to authorize MASS to access your Centrelink or DVA information.
- Review and ensure all fields are completed accurately and sign the form, followed by the date of signing.
- Once completed, you can save your changes, download the form, print it, or share it as necessary to submit it to a MASS Service Centre.
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