Get Au Pssaplpc04 2021-2025

The AU PSSapLPC04 form is essential for extending your lifePLUS insurance cover while on leave without pay or reduced pay for more than 24 months. This guide provides clear and supportive instructions for filling out the form online to ensure your coverage remains active.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the form and launch it in your preferred editor.
2. Enter your personal details, including your PSSap member number, title, surname, given names, and date of birth. Ensure all information is accurate.
3. Provide your residential and postal addresses. If your postal address is the same as your residential address, indicate that by writing 'AS ABOVE'.
4. Fill in your leave details, specifying the new anticipated return to work date, along with the start and expected end dates of your leave without pay.
5. Explain what you will be doing during your leave, such as travel or personal commitments.
6. Sign and date the declaration, confirming that all information provided is complete and correct, and that you have understood the terms of the PSSap PDS and the Insurance booklet.
7. Once completed, either save your changes, download a copy, print the form, or share it as needed. Submit the form to the provided email or postal address.

Take the step towards maintaining your insurance coverage by completing the AU PSSapLPC04 form online today.