Centrepay deduction form

I authorise Tas Gas Retail to advise Centrelink:

• To make the nominated deduction each fortnight from my current Centrelink payment(s) in respect of my agreement with Tas Gas Retail.
• To vary the deductions or target amount or suspend the nominated deduction from time-to-time to ensure my obligations under my arrangement to pay by installments are met.
• Of my correct account or billing number, if required.

I give permission for Centrelink to pay the amounts directly to Tas Gas Retail. I understand that:

• It is my choice to have the amounts deducted from my Centrelink account and that I can change or cancel the deduction at any time by contacting Tas Gas Retail or Centrelink.
• If I transfer to another eligible Centrelink payment in the future that my current deductions will continue.
• If I finalise my Tas Gas Retail account I must stop my Centrelink deduction. If I do not, Tas Gas Retail will instruct Centrelink to stop the deduction.
• Centrelink will notify me of any changes to my deduction details, including changes requested by Tas Gas Retail.
• I understand that if my deductions from my Centrelink benefits are cancelled for any reason, I am still required to make the agreed repayments on my arrangements to pay by installments.
• My consent will be noted on my account with Tas Gas Retail.

Privacy
Your personal information is protected by law. Centrelink may give your information to Tas Gas Retail for the purposes of:

• Checking your account number and amount you want to pay.
• Reconciling your payment deduction details.

Tas Gas Retail may give your personal information to Centrelink for the purposes of:

• Establishing a Centrepay agreement to make payments on your arrangements to pay by installments
• Setting a target amount, equal to your current agreed payment plan, for the Centrepay deduction
• Updating deduction or target amounts as required

You may correct or update your personal information by contacting Tas Gas Retail.
Declaration