Seasonal Work Contract

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					                                                                                                   Seasonal, Contract and
                                                                                                 Intermittent Work Details




SCI
                                        Your full name

                                        Date of birth            /       /                 CRN

                                        Phone number      (      )
                                        Partner’s name
                                        (if applicable)
This form is part of your claim for payment. The information asked for on this form is needed to decide whether Centrelink can grant your claim.
Under section 192 of the Social Security (Administration) Act 1999, Centrelink has the authority to collect this information.
Under section 196 of the Social Security (Administration) Act 1999, you must complete and return this form within 14 days.
1     Please list the work you and/or your partner have done in the last 6 months that was seasonal, contract or intermittent.
      If you and/or your partner have done more than 4 jobs, please attach a separate sheet with details.
       Seasonal work is work that is available for part or parts of the year at approximately the same time each year.
       Contract work is any intermittent work that is performed under a contract for a specific function and/or period including sub-contract work.
       Intermittent work is work that is available from time to time, can reasonably be predicted to end or not be available for a period, is less
       than a year in duration and does not accrue leave entitlements.
       Allowable Deductions can be made if they are in relation to the seasonal, contract or intermittent work and are allowed by the Australian
       Taxation Office.

1 Type of work (e.g. fishing)                   Work completed by            2 Type of work (e.g. fishing)                     Work completed by
                                                You       Your partner                                                         You       Your partner
Employer and contact details                                                 Employer and contact details




Period worked                                      Gross amount earnt        Period worked                                        Gross amount earnt
Date started work          Date finished work      from this work            Date started work          Date finished work        from this work
       /       /                  /     /             $                             /       /                  /      /              $
Allowable deductions (if any) for this work and amount                       Allowable deductions (if any) for this work and amount
                                                      $                                                                              $
                                                      $                                                                              $
                                                      $                                                                              $
                                                      $                                                                              $
If there are more deductions,                Total $                         If there are more deductions,                Total $
attach a separate sheet with details.                                        attach a separate sheet with details.
List the gross earnings from any other work or employment undertaken         List the gross earnings from any other work or employment undertaken
by you and/or your partner during the period of work detailed above          by you and/or your partner during the period of work detailed above
                                                      $                                                                              $
                                                      $                                                                              $
                                                      $                                                                              $
                                                      $                                                                              $
If there are more deductions,                Total $                         If there are more deductions,                Total $
attach a separate sheet with details.                                        attach a separate sheet with details.




                                                                                                              CLK0SU496 1005


SU496.1005                                                               1 of 2
3 Type of work (e.g. fishing)                     Work completed by            4 Type of work (e.g. fishing)                      Work completed by
                                                  You       Your partner                                                          You       Your partner
Employer and contact details                                                   Employer and contact details




Period worked                                        Gross amount earnt        Period worked                                         Gross amount earnt
Date started work            Date finished work      from this work            Date started work             Date finished work      from this work
       /       /                   /      /             $                               /          /               /      /             $
Allowable deductions (if any) for this work and amount                         Allowable deductions (if any) for this work and amount
                                                        $                                                                               $
                                                        $                                                                               $
                                                        $                                                                               $
                                                        $                                                                               $
If there are more deductions,                 Total $                          If there are more deductions,                   Total $
attach a separate sheet with details.                                          attach a separate sheet with details.
List the gross earnings from any other work or employment undertaken           List the gross earnings from any other work or employment undertaken
by you and/or your partner during the period of work detailed above            by you and/or your partner during the period of work detailed above
                                                        $                                                                               $
                                                        $                                                                               $
                                                        $                                                                               $
                                                        $                                                                               $
If there are more deductions,                 Total $                          If there are more deductions,                   Total $
attach a separate sheet with details.                                          attach a separate sheet with details.

 Note: You need to supply verifying documents to support the information you have provided on this form. Verifying documents can be payslips,
 invoice books, group certificates, profit and loss statements, wage books, bank statements, time sheets or by a letter from the employer.


2     Have you attached verification documentation?                                 5       Statement
      No                                                                                    I declare that:
      Yes                                                                                   • the information provided in this form is complete and correct.
                                                                                            • I have received the Information Booklet which includes the
                                                                                               privacy notice.
3     Did you have a partner during the last 6 months?
      No           Go to 5                                                                  I understand that:
                                                                                            • I may need to provide further information if requested.
      Yes          Go to next question
                                                                                            • giving false or misleading information is a serious offence.
                                                                                            • Centrelink can make relevant enquiries to ensure I receive the
4     Were you with the same partner for the whole 6 months?                                   correct entitlement.
      No           Give details
                                                                                            Your Signature




                                                                                            Date
                                                                                                       /     /


      Yes          Go to next question




SU496.1005                                                                 2 of 2

				
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Description: Seasonal Work Contract document sample