Flood Support (Derwent Valley) September 2024

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Tasmanian Emergency Assistance Grants

* indicates a required field.

Eligibility

NOTE - THIS IS NOT THE APPLICATION FORM FOR THE $350 FOOD RELIEF GRANT FUND. 

THIS APPLICATION FORM IS FOR FLOOD AFFECTED HOUSEHOLDS IN THE DERWENT VALLEY AREA.

FOR POWER OUTAGE / FOOD RELIEF GRANTS PLEASE APPLY HERE 

 

This grant for financial assistance is for Tasmanian Residents only.

Before completing this form, please ensure that you are eligible to apply for Emergency Assistance.

Identification and Eligibility

  • Identification must be provided, including evidence of residential address and family composition (such as a Medicare card) where indicated in this form.
  • Individuals and families must reside in areas impacted by the emergency event.
    • The eligible areas are areas listed in TasALERT.
    • The individual or family must have been:
      • directed or advised by a relevant authority, such as Tasmanian Fire Service, SES, or TASPOL, to evacuate from their residence,
      • displaced from their residence due to the emergency event,
      • unable to return to your principal place of residence or isolated due to an emergency event, and
      • be in need of financial support to obtain essential and appropriate shelter, clothing, food, transport and/or personal items.

Eligibility Check - Emergency Assistance Grant

Are you eligible for an Emergency Assistance Grant? * Required
Response required.
Attach a file: Select stored file

    Emergency event location

    Please provide the local government area of your residence affected by the emergency event that led to your need for an Emergency Assistance.

    Is this application form being completed at a recovery, evacuation, Service Tasmania or authorised support centre? * Required

    Location of recovery, evacuation or call centre (Not Applicable)

    This section is not applicable because of your response to question: "Is this application form being completed at a recovery, evacuation, Service Tasmania or authorised support centre?" on page 1

    Please enter the address of the recovery, evacuation or call centre that this application form is being completed at.

    Please enter the address of the recovery, evacuation or call centre

    Applicant details

    Please enter your details in the section below.
     
    The Department of Premier and Cabinet (DPAC) pledge to respect and uphold your rights to privacy protection under the Australian Privacy Principles (APPs) as established under the Privacy Act 1988 and amended by the Privacy Amendment (Enhancing Privacy Protection) Act 2012.

    Please note by submitting this request you:

    • are agreeing to allow DPAC to share your information for the purposes of assessing and processing your request, and
    • acknowledge that some information in relation to this request such as the your name, funding purpose, amount, location and any other details the department may consider appropriate will be made public as part of a fair and transparent process when disbursing public funds.
    Please enter your name as shown on your identification evidence
    Please enter your date of birth (dd/mm/yyyy)
    Please provide the address of your principal residence at the time of the emergency event
    You must provide a phone number that you can be contacted on (landline or mobile). Please include the area code in brackets if using a landline, e.g. (03)12345678
    Please include the area code in brackets if using a landline, e.g. (03)12345678
    Please ender a valid email address so we can send you application confirmation and update emails

    Identification

    You must provide evidence of your identification and current residential address. Please select your identification type(s) below that you are providing with your application.

    Note - Your Tasmanian driver's licence or Personal Information Card is the quickest and simplest form of evidence to verify your identification and residential address.

    IMPORTANT

    Your application MUST include evidence of your identification and current residential address.

    Photo Identification * Required
    Response required.Response required.
    At least 1 choice must be selected. Providing photo identification will assist us process your application quicker

    Photo Identification Evidence (Not Applicable)

    This section is not applicable because of your response to question: "Photo Identification" on page 1

    Attach a file: Select stored file
      Please attach identification and residential address evidence

      Address Confirmation (Not Applicable)

      This section is not applicable because of your response to question: "Photo Identification" on page 1

      Does the address on your photo identification match your current residential address? * Required
      If the address on your photo identification does not match your current address, supplied in this application form, you will be asked to provide additional address evidence.

      Personal Identification (Not Applicable)

      This section is not applicable because of your response to question: "Photo Identification" on page 1

      Additional Personal Identification * Required
      Response required.Response required.
      At least 1 choice must be selected. 
      Attach a file: Select stored file
        Please provide any additional comments in regards to your identification and evidence details

        Address Evidence (Not Applicable)

        This section is not applicable because of your response to questions:

        • "Photo Identification" on page 1
        • "Does the address on your photo identification match your current residential address?" on page 1
        Additional Address Evidence - not more than 6 months old. * Required
        Response required.Response required.
        At least 1 choice must be selected. MUST show your name, address and not be dated longer than 6 months ago.
        Attach a file: Select stored file
          Please use this section to advise of any relevant information in relation to your current residential address.

          Emergency Assistance Grant amount

          The available grant amount to you and your family at the same residential address is:

          • $250 per adult (18 years and over);
          • $125 per child (under 18 years); and
          • up to $1,000 for any one family.

          Examples:

          • A household with one adult and two dependent children is eligible to apply for a grant of $500 ($250 + $125 + $125 = $500).
          • A household with two adults and four dependent children is eligible to apply for a grant of $1,000 ($250 +$250 + $125 + $125 + $125 +$125 = $1,000).

          Important: The total grant amount is calculated based on the information you provide, whilst your total amount below may show more than $1,000, the maximum amount a household can receive is capped at $1,000.

          Number of adults (18 and over) living in the principal residence. Please enter 0 if none.
          Number of children (Under 18) living in the principal residence. Please enter 0 if none.
          This number/amount is calculated. 
          This number/amount is calculated. 

          Grant Requested (Not Applicable)

          This section is not applicable because of your response to question: "Grant Calculation" on page 1

          This number/amount is calculated. 

          Maximum Grant $1,000 (Not Applicable)

          This section is not applicable because of your response to question: "Grant Calculation" on page 1

          Please note that the maximum amount you can received per family is capped at $1,000.

          This number/amount is calculated. 

          Medicare details (Not Applicable)

          This section is not applicable because of your response to question: "Total adults and children applying for emergency assistance." on page 1

          Your Medicare Card number is required as evidence of family composition when including family members in this application.

          Must be 10 numbers with no spaces
          Attach a file: Select stored file

            Family member details (Not Applicable)

            This section is not applicable because of your response to question: "Total adults and children applying for emergency assistance." on page 1

            Please enter the full name and age of the family members that are being included in this application.

            NOTE: to be eligible for funding family members must be shown on your MedicareCard

            You can add more family members by clicking the 'Add More' button.

            Full nameAge
            Please enter Full name
            Please enter Age in Years. Enter "1" if child is less than 12 months.
             * Required
             * Required

            Must be at least 1 rows

            Additional Adult(s) Identification (Not Applicable)

            This section is not applicable because of your response to question: "Number of adults you are applying for (18 and over)" on page 1

            You're claiming for more than 2 adults. Please provide identification evidence for all adults claimed in the application, showing their Date of Birth to confirm eligibility.

            Failure to provide evidence may affect the total amount of grant that can be received.

            Attach a file: Select stored file

              Total Grant Requested

              This number/amount is calculated. This is the total financial support you are requesting in this application.

              Bank account details

              Subject to your application being approved, payment of the grant will be made by direct deposit into the applicant's nominated bank account. If your bank uses OSKO you will receive your payment even sooner. To check if your bank uses OSKO check at Search for your Bank to Get Started - Osko by BPAY

              Please note, incorrect bank details will delay the payment of the grant.

              BSB will be validated and must be 6 numbers only

              Declaration statement

              I certify that to the best of my knowledge the statements made within this application are true and correct, and I understand that if my request is approved for funding, this request and any subsequent documentation in relation to this funding will form the terms and conditions of the funding provided. I also agree to cooperate with the department to provide any additional information on request that relates to this emergency support.

              I authorise officers of the Tasmanian State Service to make any enquiries thought necessary to verify the information I have provided. I understand that if this claim is fraudulent, it will be reported to the relevant authorities.

              By selecting Yes and submitting this request, I agree to the above declaration statement. * Required
              Please provide any additional comments you may have in relation to this application
              Attach a file: Select stored file
                You can attach any additional information here to support your application.