Pension Concession Application Form

Eligible pensioners are able to apply for a rebate against their rate account. To be assessed for a pensioner concession, please complete the below form or an application can also be made by submitting a Pension Concession Application Form to Council.

Application for Council Pensioner Concession Rates Rebate

If joint owners are eligible for a pensioner concession and they are not spouses, a separate form will need to be completed by each owner to receive the maximum rebate, otherwise only a partial rebate will be granted.

The information contained in this application form and any information requested for the purpose of assessing eligibility for a pensioner concession is required under the Local Government Act 1993 and the Local Government (General) Regulation 2005.

By submitting this form, you declare that the information provided is true and correct and that you are the person making this application. If you make a false statement in an application, you may be guilty of an offence and fined up to $2,220.


The information provided on this form is private and confidential and your Council must not disclose the information to any person or body, if it is not directly related to the purpose for which the information was collected.

If you have a complaint about the use of your personal information, contact your Council’s Public Officer. The information contained or referred to in this application form may be corrected and updated by you, by contacting your Council.

Please read the conditions and tick the box below to confirm your consent to your Council checking your concession eligibility with Centrelink or the Department of Veterans’ Affairs.

I consent:

• Council to use Centrelink Confirmation eServices to perform a Centrelink/DVA enquiry of my Centrelink or Department of Veterans’ Affairs customer details and concession card status to enable Council to determine if I qualify for a rebate.

• The Australian Government Department of Human Services (the department) to provide the results of that enquiry to Council.

I understand that:

• The department will disclose personal information to Council including my name, address, payment type, payment status and concession card type and status to confirm my eligibility for a rebate.

• This consent, once signed, remains valid while I am a customer of Council unless I withdraw it by contacting Council or the department.

• I can get proof of my circumstances/details from the department and provide it to Council so my eligibility for a rebate can be determined.

• If I withdraw my consent or do not alternatively provide proof of my circumstances/details, I may not be eligible for the rebate provided by Council.


Pension Concession Application Form