Get Au Pssaplpc04 2016-2025

Filling out the AU PSSapLPC04 form is an essential step for users intending to take leave greater than 24 months and wishing to maintain their insurance cover. This guide provides clear instructions to help users complete the form accurately and efficiently.

Follow the steps to fill out the AU PSSapLPC04 form online.

1. Press the ‘Get Form’ button to access the form and open it in the editor.
2. In section A, provide your personal details including your PSSap member number, salutation, surname, given names, date of birth, residential address, postal address, phone numbers during business hours, after hours, and your mobile number, along with your email address.
3. In section B, input your leave details: indicate the new return to work date, the expected start and end dates of your leave, and describe what you will be doing while on leave without pay or reduced pay.
4. Specify your residential address during your leave, ensuring to include the suburb, state or province, and postcode, as well as the postal address. If the postal address is the same as the residential address, write ‘AS ABOVE’.
5. In section C, review and confirm the declaration by checking all statements to ensure you understand and agree with the conditions of your application. Provide your signature and the date when you sign the form.
6. Once completed, save your changes, download the filled form, and share it if necessary before posting it to the specified address, as faxed or emailed copies cannot be accepted.

Complete your forms online today to ensure your insurance cover remains intact.