Application For Housing Assistance Form Page 16

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A2. Do any additional persons own (or part
Yes
No
Go to A3.
own) any residential or commercial
give details
property or land (including any
Name of additional person
Address of the property or land
property overseas)?
See item 7 on the Evidence Requirements
Information Sheet for details.
A3.
List the income of each additional person aged 18 years and over.
You are required to list each type of income received by each person. If your partner is under 18 years of age, list their income.
Note: Income includes pension payments (including overseas pension), allowances, child support payments, wages, casual
earnings, income from self-employment, regular insurance payments, interest from the bank, interest from investments, income
from property ownership, etc.
If any of the additional persons receives a Centrelink benefit, they can include their details on the Income Confirmation Scheme
(ICS) Consent Authority on page 16 of this form or on a separate community housing income confirmation form. By signing the
ICS Authority, they give permission for FACS to contact Centrelink to check their income and they will not need to provide any
further evidence of their Centrelink payment.
See item 8 on the Evidence Requirements Information Sheet for details.
Name of additional person
Type of income
Paid
Amount of income
Weekly
$
Fortnightly
Weekly
$
Fortnightly
Weekly
$
Fortnightly
Weekly
$
Fortnightly
Weekly
$
Fortnightly
Weekly
$
Fortnightly
A3a. List the savings/financial assets of each additional person aged 18 years and over.
You are required to list each type of financial asset owned by each person. If your partner is under 18 years of age, list their
assets.
Note: Include all bank accounts, savings accounts, cash, shares, term deposits, etc.
See item 9 on the Evidence Requirements Information Sheet for details.
Name of additional person
Type of financial asset
Value of asset
$
$
$
$
$
$
DH3001 04/15
Page 14 of 16

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