Carer Payment and Carer Allowance – Medical Report (SA431) for a child under 16 years Instructions
This form contains 21 fields organized into 4 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Carer Contact Details (Address, Postcode, Daytime Phone) | ||
| Carer address — line 1 (street address) | Text |
Enter the carer's primary street address including unit or flat number and street name.
|
| Carer address — line 2 (suburb / state / additional info) | Text |
Enter the carer's suburb and state/territory and any additional address details such as PO Box or locality.
|
| Carer postcode | Text |
Enter the carer's postcode (for Australian addresses enter the 4‑digit postcode).
|
| Carer daytime phone number | Text |
Enter the carer's daytime telephone number, including area code or country code if required.
|
| Carer Identification (Name, Date of Birth, CRN) | ||
| Carer name | Text |
Enter the carer’s full name (given names and family name) as it should appear on official records.
|
| Carer date of birth — Day (DD) | Text |
Enter the day portion of the carer’s date of birth as two digits (DD).
|
| Carer date of birth — Month (MM) | Text |
Enter the month portion of the carer’s date of birth as two digits (MM).
|
| Carer date of birth — Year (YYYY) | Text |
Enter the year portion of the carer’s date of birth as four digits (YYYY).
|
| Carer CRN — box 1 | Text |
Enter the first character (digit/letter) of the carer’s Customer Reference Number (CRN) for this box.
|
| Carer CRN — box 2 | Text |
Enter the second character (digit/letter) of the carer’s Customer Reference Number (CRN) for this box.
|
| Carer CRN — box 3 | Text |
Enter the third character (digit/letter) of the carer’s Customer Reference Number (CRN) for this box.
|
| Carer CRN — box 4 | Text |
Enter the fourth character (digit/letter) of the carer’s Customer Reference Number (CRN) for this box.
|
| Child Details (Name, Date of Birth, CRN) | ||
| Child's full name | Text |
Enter the child's full legal name (given names and family name) as you want it recorded on the form.
|
| Date of birth – day | Date |
Enter the day component of the child's date of birth.
|
| Date of birth – month | Date |
Enter the month component of the child's date of birth.
|
| Date of birth – year | Date |
Enter the year component of the child's date of birth.
|
| Child's CRN – part 1 | Text |
Enter the first section of the child's Customer Reference Number (CRN) as shown on Centrelink correspondence.
|
| Child's CRN – part 2 | Text |
Enter the second section of the child's Customer Reference Number (CRN) as shown on Centrelink correspondence.
|
| Child's CRN – part 3 | Text |
Enter the third section of the child's Customer Reference Number (CRN) as shown on Centrelink correspondence.
|
| Child's CRN – part 4 | Text |
Enter the final section of the child's Customer Reference Number (CRN) as shown on Centrelink correspondence.
|
| General | ||
| Clear | Button | |