Application for Review Form

Transcription

1 Application for Review Form AAT first review of a child support decision Do you disagree with a decision of the Child Support Registrar? The AAT provides quick, fair and independent review of certain decisions about child support. Contact details Telephone International applicants (reverse charges accepted) Website Teletypewriter service (TTY) Information in other languages For information in another language, call from anywhere in Australia and from outside of Australia. The Translating and Interpreting Service can call us on your behalf. The AAT is independent The Child Support Registrar is part of the Department of Human Services. The AAT is not part of that Department. Most child support decisions can be reviewed by the AAT. The AAT can review a decision of the Child Support Registrar made on an objection. The AAT can affirm, vary or set aside the decision under review. The AAT can also review a decision of the Child Support Registrar to refuse an extension of time in which to lodge an objection. There is no fee for applying to the AAT for a first review of a child support decision. Making an application To make an application for review: Apply online at or Call the AAT on ; or Fill in this form and: - Post it to the AAT (GPO Box 9943 in your capital city); - Take it to your nearest AAT office; or - Fax it to your nearest AAT office; Important: If you need to apply for an extension of time in which to seek review, you must make an application in writing (see page 2 of this form). The AAT hearing The hearing is held in private. With the permission of the AAT, a party may have another person make submissions at the hearing. To protect the privacy of the parties, other persons are NOT usually permitted to be present in the hearing. Children are not permitted to give evidence or attend the hearing. Read the Child Support Review Directions (which can be accessed on the AAT s website www. aat.gov.au) so that you know what else you must do as well as filling out this form. 1 of 4

2 Application for Review Form AAT first review of a child support decision Do you need help filling in this form? Ask a friend, a community worker or call the AAT on What is the child support decision that you would like the AAT to review?* (Please tick) OR A decision of the Child Support Registrar made on an objection to a decision. Date of decision on the objection...date decision received... Important: If the decision you want the AAT to review has not been the subject of an objection to the Child Support Registrar, then the AAT cannot review the decision. Please contact the Department of Human Services. A decision of the Child Support Registrar to refuse an application for an extension of time to lodge an objection. Date of decision...date decision received... If possible, please attach a copy of the decision. If you live in Australia and it has been more than 28 days since you were given notice of the child support decision (other than a decision on an objection to a care percentage decision), you are out of time to lodge this application. To apply for an extension of time, please tick the box below and complete the rest of this form. If you live overseas and it has been more than 90 days since you were given notice of the child support decision (other than a decision on an objection to a care percentage decision), you are out of time to lodge this application. To apply for an extension of time, please tick the box below and complete the rest of this form. Yes I wish to apply for an extension of time to apply for an AAT review of a decision of the Child Support Registrar. If you are applying for an extension of time, you must state your reasons in writing for failing to apply for review by the AAT within 28 days of receipt of notice of the decision on the objection or the decision to refuse time in which to lodge an objection (or within 90 days if you live overseas). Important: Attach additional pages to explain your reasons for delay and any documents that you want taken into account because the decision on your application for an extension may be made without further contact with you. 2 of 4

3 Application for Review Form AAT first review of a child support decision Your details Title: Mr Ms Mrs Miss Other... Last name:... First name:... Date of birth:... Residential address:...postcode:... Postal address, if different:... Postcode:... Telephone number (B/H):... Mobile telephone number:... Would you like the AAT to correspond with you by ? Yes No address:... Your Child Support reference number, if known:... Your application Are you the: Payer Payee Other If other, please state:... If other, you must attach evidence of your authority to make this application. What decision would you like reviewed? If possible, attach a copy of the decision. Why do you think this decision is incorrect? Important: Please ensure that you fully explain your reasons for requesting a review of the decision. We cannot start your review if you do not answer this question. You must answer these questions Have you obtained a family violence order against the other parent? Yes No 3 of 4

4 Application for Review Form AAT first review of a child support decision If yes, you must attach a copy of the family violence order or send a copy to the AAT within 14 days. How would you prefer to make your submissions to the AAT? Come to the AAT Telephone Do you need an interpreter to assist you during the hearing? Yes No If yes, what language or dialect do you speak or sign?... Do you have a disability-related need for the hearing? Yes No If you answered yes, a tribunal officer will contact you. If you want someone to make submissions to the AAT on your behalf, you must also answer these questions Name ofperson:... Relationship to you (e.g. lawyer, community advocate, spouse or relative):... Postal address (if person is not your spouse):... Telephone number of person:... Type of submissions for which permission is sought: Oral Written Oral and written Reasons for wanting person to make submissions:... Important: The wishes of the other party and the need to protect his or her privacy must be taken into account before permission is given for another person to make submissions on your behalf. Optional questions Answers to these questions indicate whether the availability of review by the AAT is known in a particular section of the community. Are you of Aboriginal or Torres Strait Islander origin? Yes No Were you born overseas? Yes No If yes, which country?... What languages do you speak at home?... Please sign here Your signature:...date:... Privacy information Please note that the AAT will disclose information relevant to your application for review to the other parent or non-parent carer (as the case may be) and may disclose your information to government agencies if required. Further information on the AAT s privacy policy is available at or by calling of 4

5 Statement of Financial Circumstances (Child support reviews) Your financial circumstances are relevant to the AAT s decision. This form must be completed and returned to the AAT within the timeframe specified in the letter. Please note that any information collected by the tribunal will be made available to all other parties to the review, including the Child Support Registrar. PART A About you 1. What is your last name as used now? Given names? PART B Financial Summary IMPORTANT: As you complete the rest of this form you will be asked to transfer the totals for Parts D, F-K to this summary 2. i. Your total average income (THIS IS THE FIGURE AT ITEM 16) ii. Total value of property owned by you (THIS IS THE FIGURE AT ITEM 27) iii. Total gross value of your superannuation (THIS IS THE FIGURE AT ITEM 28) iv. Total of your liabilities (THIS IS THE FIGURE AT ITEM 37) v. Total of your financial resources (THIS IS THE FIGURE AT ITEM 39) vi. Your total personal expenditure (THIS IS THE FIGURE AT ITEM 46) vii. Your total household expenditure (THIS IS THE FIGURE AT ITEM 48) STATEMENT I declare that the information on this form is complete and correct. Signature:... Date:... PART C Your employment details 3. What is your usual occupation? 4. What is the name of your employer?

6 5. What is the address of your employer? STATE POSTCODE PHONE 6. How long have you been employed at this place? YEARS MONTHS DAYS 7. Your employment status? FULL-TIME PART-TIME PERMANENT CASUAL ON CONTRACT 8. Are you self-employed? NO YES - STATE THE NAME OF THE BUSINESS / COMPANY / PARTNERSHIP / TRUST NAME: PART D Your income Note: give weekly amounts in whole dollars. If the amount for an item is nil, write nil. If you can only give an estimate insert the letter e before the amount stated. 9. Total salary or wages before tax AVERAGE WEEKLY AMOUNT 10. Investment income before tax INCOME TYPE (e.g. rent, interest, dividend) INCOME TYPE (e.g. rent, interest, dividend) AVERAGE WEEKLY AMOUNT 11. Income from business/partnership/company/trust NAME OF BUSINESS/ PARTNERSHIP/COMPANY/TRUST TYPE OF BUSINESS ADDRESS OF BUSINESS/ PARTNERSHIP/COMPANY/TRUST STATE POSTCODE AVERAGE WEEKLY AMOUNT Page 2 of 9

7 AVERAGE WEEKLY AMOUNT 12. Government benefits TYPE OF BENEFIT TYPE OF BENEFIT 13. Maintenance/child support PAID BY ACTUALLY RECEIVED FOR THE BENEFIT OF Required to be paid Maintenance/child support PAID BY ACTUALLY RECEIVED FOR THE BENEFIT OF Required to be paid 14. Benefit from employment/business TYPE OF BENEFIT TYPE OF BENEFIT 15. Other income PAID BY TYPE OF BENEFIT 16. TOTAL AVERAGE WEEKLY INCOME WRITE THIS ITEM 16 TOTAL AT QUESTION 2 (i) ON PAGE 1 OF THIS FORM PART E Other income earners in your household 17. Give the name, age and relationship to you and gross income of each other occupant of your household AGE RELATIONSHIP TO YOU AVERAGE WEEKLY AMOUNT Page 3 of 9

8 PART F Property owned by you CURRENT VALUE OF YOUR SHARE 18. Home FULL NAME OF THE REGISTERED OWNERS 19. Other real estate REGISTERED OWNERS REGISTERED OWNERS 20. Funds in banks, building societies, credit unions or other financial institutions CURRENT BALANCE CURRENT BALANCE 21. Investments 22. Life insurance policies 23. Motor vehicle YEAR MAKE MODEL YEAR MAKE MODEL 24. Interest in a business including a business operated by you as a sole trader, in a partnership or through a proprietary company or a trust NAME OF BUSINESS ADDRESS OF BUSINESS Business type (Mark [X] which applies) Sole Trader Partnership Proprietary company/trust Page 4 of 9

9 25. Household contents 26. Other personal property SPECIFY 27. TOTAL VALUE OF PROPERTY OWNED BY YOU WRITE THIS ITEM 27 TOTAL AT QUESTION 2 (ii) ON PAGE 1 OF THIS FORM PART G Superannuation GROSS VALUE 28. Interest in superannuation NAME OF SUPERANNUATION PLAN TYPE OF INTEREST Accumulated interest Partially vested accumulation interest Defined benefit interest Self-managed fund Retirement saving account Small superannuation interest Percentage only interest Approved deposit fund INFORMATION ABOUT ANY OTHER SUPERANNUATION PLANS TOTAL VALUE OF YOUR SUPERANNUATION WRITE THIS ITEM 28 TOTAL AT QUESTION 2 (iii) ON PAGE 1 OF THIS FORM PART H Your Liabilities AMOUNT OF YOUR SHARE 29. Home mortgage FULL NAME OF ALL BORROWERS 30. Other mortgages FULL NAME OF ALL BORROWERS Page 5 of 9

10 31. Total income tax assessed and unpaid for the most recent financial year Date due / / 32. Total income tax assessed and unpaid in previous financial years 33. Loans NAME OF LENDER TYPE OF LOAN (Mark [X] which applies) over draft personal loan other (specify) FULL NAME OF ALL BORROWERS 34. Credit/charge cards SPECIFY CARD PROVIDER AND TYPE SPECIFY CARD PROVIDER AND TYPE 35. Other personal liabilities SPECIFY FULL NAME OF OTHER LIABLE PERSON 36. Other personal business liabilities SPECIFY FULL NAME OF OTHER LIABLE PERSON 37. TOTAL LIABILITIES WRITE THIS ITEM 37 TOTAL AT QUESTION 2 (iv) ON PAGE 1 OF THIS FORM PART I Financial resources 38. Other financial resources SPECIFY 39. TOTAL FINANCIAL RESOURCES WRITE THIS ITEM 39 TOTAL AT QUESTION 2 (v) ON PAGE 1 OF THIS FORM Page 6 of 9

11 PART J Personal expenditure Note: give weekly amounts in whole dollars. If the amount for an item is nil, write nil. If you can only give an estimate insert the letter e before the amount stated. AVERAGE WEEKLY AMOUNT 40. Total income tax 41. Superannuation PLAN NAME 42. Life Insurance premiums TYPE OF POLICY 43. Maintenance payments/child support PAID FOR THE BENEFIT OF assessment agreement order AMOUNT OF ASSESSMENT, AGREEMENT OR ORDER 44. Minimum credit card payments CARD TYPE Minimum payment NAME OF COMPANY 45. Health insurance premiums NAME OF HEALTH FUND 46. TOTAL PERSONAL EXPENDITURE WRITE THIS ITEM 46 TOTAL AT QUESTION 2 (vi) ON PAGE 1 OF THIS FORM Page 7 of 9

12 PART K Household expenses 47. Average weekly expenses NOTE: GIVE WEEKLY AMOUNTS IN WHOLE DOLLARS. IF THE AMOUNT FOR AN ITEM IS NIL; WRITE NIL. IF YOU CAN ONLY GIVE AN ESTIMATE INSERT THE LETTER E BEFORE THE AMOUNT STATED. ITEM TOTAL FOR YOU FOR CHILDREN (IF APPLICABLE) OTHER ADULTS (IF APPLICABLE) Food Rent / Mortgage Household supplies House repairs Gas Electricity Heating fuel Water charges Telephone Council Rates & Levies Motor vehicle - petrol - maintenance - registration Fares / car parking Clothing and shoes Children s activities Child minding Medical, dental and optical (not including health insurance premiums) Insurance (excluding health / life) Entertainment / hobbies Holidays Education expenses, including fees and levies Chemist / pharmaceutical Gardening / lawn mowing Cleaning (house / pool) Repairs furnishings and appliances Dry cleaning Books and magazines Gifts Hairdressing, toiletries Other necessary commitments (specify) TOTAL 48. TOTAL HOUSEHOLD EXPENDITURE WRITE THIS ITEM 48 TOTAL AT QUESTION 2 (vii) ON PAGE 1 OF THIS FORM Page 8 of 9

13 PART L Additional information You should set out here or on an additional page any item that you may not be able to include in any section of the document. Please include the part and paragraph number that it continues from. Page 9 of 9