Centrelink Form SY015 - Verification of 'Unreasonable to Live at Home' Instructions
This form contains 117 fields organized into 45 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Attempted to Sort Out Differences | ||
| DummyCalcQ11 | Text | |
| No | Checkbox |
Check this box if you and/or your child have not tried to sort out your differences. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Yes | Checkbox |
Check this box if you and/or your child have tried to sort out your differences. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Child Previously Left Home | ||
| No | Checkbox |
Check this box if your child has not previously left home. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Yes | Checkbox |
Check this box if your child has previously left home and you need to provide details. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Child's Ability to Live with Other Parent/Guardian | ||
| No | Checkbox |
Check this box if your child is not able to live with their other parent or guardian. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Yes | Checkbox |
Check this box if your child is able to live with their other parent or guardian. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Details of Child's Ability to Live with Other Parent/Guardian | Text |
Provide details regarding your child's ability to live with their other parent or guardian, including a description of their relationship and how they interact. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Child's Contact with Other Parent/Guardian | ||
| Years Since Last Contact | Number |
Enter the number of years since your child last had contact with their other parent or guardian. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| No | Checkbox |
Check this box if your child has not had any contact with their other parent/guardian in the past 2 years. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Not sure | Checkbox |
Check this box if you are not sure whether your child has had any contact with their other parent/guardian in the past 2 years. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Yes | Checkbox |
Check this box if your child has had contact with their other parent/guardian in the past 2 years. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Child's Current Living Situation | ||
| Child Not Living with Parent | Text |
Indicate if the child is not currently living with the parent or guardian.
|
| No | Checkbox |
Check this box if your child does not currently live with you.
|
| Yes | Checkbox |
Check this box if your child currently lives with you.
|
| Child's Date of Birth | ||
| Child's Date of Birth | Date |
Please provide the child's date of birth.
|
| Child's Name | ||
| Child's Family Name | Text |
Enter the family name of the child.
|
| Child's First Given Name | Text |
Enter the first given name of the child.
|
| Child's Second Given Name | Text |
Enter the second given name of the child.
|
| Child's Past Living Arrangement with Other Parent/Guardian | ||
| No | Checkbox |
Check this box if your child has never lived with their other parent or guardian. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Yes | Checkbox |
Check this box if your child has, at any point, lived with their other parent or guardian. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Conditions for Child's Return | ||
| No | Checkbox |
Check this box if no conditions will apply if you allow your child to return home to live.
|
| Yes | Checkbox |
Check this box if conditions will apply if you allow your child to return home to live.
|
| Conditions Indicator | Text |
Enter any brief indicator or reference related to the conditions for the child's return, if applicable. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Conditions for Child's Return Details | Text |
Provide a detailed explanation of any conditions that must apply if you allow your child to return home to live. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Contact Since Leaving Home | ||
| No | Checkbox |
Check this box if you have not had any contact with your child since they left home.
|
| Yes | Checkbox |
Check this box if you have had contact with your child since they left home.
|
| Contact Confirmation | Text |
Please confirm if you had any contact with your child since they left home. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Details of Contact | Text |
Provide comprehensive details about the contact made with your child since they left home, including the type, frequency, and who initiated it. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Date Child Left Home | ||
| Date Child Left Home | Date |
Enter the date your child left your home. Fill only if 'No' is 'Yes'.
Depends on:
No
|
| Family Impact Details | ||
| Family Impact Description | Text |
Provide details and examples of how you and other family members were affected by the incidents or problems that led your child to leave home. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Financial Support Provided to Child | ||
| No | Checkbox |
Check this box if neither you nor any other person is providing your child with money or other support.
|
| Yes | Checkbox |
Check this box if you or any other person is providing your child with money or other support.
|
| DummyCalcQ16 | Text |
Depends on:
Yes
|
| Financial Support Details | Text |
Please provide details about the financial or other support given to the child, including the type of support provided, how often it is provided, and who is providing the support. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| First Help Attempt Details | ||
| Details of What Has Been Tried | Text |
Provide a detailed description of what actions or methods have been attempted to resolve the differences. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Contacted Person or Organisation Name | Text |
Enter the full name of the person or organisation that was contacted for help. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Duration of Contact | Text |
State the period of time for which you have been in contact with this person or organisation. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Frequency of Contact | Text |
Describe how often you have been in contact with this person or organisation. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| No | Checkbox |
Check this box if going to the person or organization did not help improve your relationship. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Yes | Checkbox |
Check this box if going to the person or organization did help improve your relationship. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| First Previous Departure Dates | ||
| First Departure Date | Date |
Enter the date your child first left home, or an estimate of that date. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| First Return Date | Date |
Enter the date your child first returned home to live, or an estimate of that date. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Fourth Previous Departure Dates | ||
| Fourth Departure Date | Date |
Please enter the fourth date your child left home, or an estimate of that date. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Fourth Return Date | Date |
Please enter the fourth date your child returned home to live, or an estimate of that date. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| General | ||
| Instructions button | Button | |
| Q1.Address1.0 | Text | |
| Q1.Address2.0 | Text | |
| Q5GoToQ27 | Button | |
| Q11GoToQ13 | Button | |
| Q12GoToQ14 | Button | |
| Q17GoToQ19 | Button | |
| Q18GoToQ20 | Button | |
| Q20GoToQ25 | Button | |
| Q21GoToQ25 | Button | |
| Q26 | Text | |
| Print button | Button | |
| Clear button | Button | |
| Information for 'Unreasonable to live at home' Rate | ||
| No | Checkbox |
Check this box if you have no other information to provide regarding your child's entitlement to the 'Unreasonable to live at home' rate. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Yes | Checkbox |
Check this box if you have additional information that can help decide if your child is entitled to the 'Unreasonable to live at home' rate. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Additional Details Reference | Text |
Please provide a brief reference or summary for the additional information being supplied. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Unreasonable to Live at Home Explanation | Text |
Please provide a detailed explanation as to why your child is entitled to the 'Unreasonable to live at home' rate, or any other relevant information. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Living with Child's Other Parent/Guardian | ||
| Question to skip to if not living with other parent/guardian | Text |
Provide the number of the question you should go to if you are not living with your child's other parent or guardian. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| No | Checkbox |
Check this box if you are NOT living with your child's other parent or guardian. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Yes | Checkbox |
Check this box if you ARE living with your child's other parent or guardian. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Other Parent/Guardian's Full Name | ||
| Full Name | Text |
Please provide the full name of the other parent or guardian.
|
| Other Parent/Guardian's Home Phone Number | ||
| Other Parent/Guardian's Home Phone Area Code | Text |
Please provide the area code for the other parent/guardian's home phone number.
|
| Other Parent/Guardian's Home Phone Number | Text |
Please provide the main part of the other parent/guardian's home phone number.
|
| Other Parent/Guardian's Mobile Phone Number | ||
| Other Parent/Guardian's Mobile Phone Number | Text |
Provide the mobile phone number for the other parent or guardian.
|
| Other Parent/Guardian's Permanent Address | ||
| Address Line 1 | Text |
Enter the first line of the other parent or guardian's permanent address.
|
| Address Line 2 | Text |
Enter the second line of the other parent or guardian's permanent address.
|
| Suburb/Town/City | Text |
Enter the suburb, town, or city of the other parent or guardian's permanent address.
|
| Postcode | Text |
Enter the postcode of the other parent or guardian's permanent address.
|
| Other Parent/Guardian's Relationship to Child | ||
| Mother | Checkbox |
Check this box if the other parent/guardian is the child's mother.
|
| Father | Checkbox |
Check this box if the other parent/guardian is the child's father.
|
| Guardian | Checkbox |
Check this box if the other parent/guardian is the child's guardian.
|
| Step parent | Checkbox |
Check this box if the other parent/guardian is the child's step parent.
|
| Parent/Guardian Partner's Signature Date | ||
| Partner's Signature Date | Date |
Provide the date when the Parent/Guardian Partner signed the form.
|
| Parent/Guardian Signature | ||
| Sign | Text | |
| Signature Date | Date |
Please enter the date the parent or guardian signed the form.
|
| Parent/Guardian Signature | Text |
Please provide the signature of the parent or guardian.
|
| Parent/Guardian's Full Name | ||
| Parent/Guardian's Full Name | Text |
Please provide the full name of the parent or guardian.
|
| Parent/Guardian's Home Phone Number | ||
| Home Phone Area Code | Text |
Enter the area code for the parent or guardian's home phone number.
|
| Home Phone Main Number | Text |
Enter the main part of the parent or guardian's home phone number.
|
| Parent/Guardian's Mobile Phone Number | ||
| Mobile Phone Number | Text |
Please provide the parent or guardian's mobile phone number.
|
| Parent/Guardian's Permanent Address | ||
| Street Address | Text |
Please provide the street number and name for the Parent/Guardian's permanent address.
|
| Suburb/Town/State | Text |
Please provide the suburb, town, or state for the Parent/Guardian's permanent address.
|
| Postcode | Text |
Please provide the postcode for the Parent/Guardian's permanent address.
|
| Parent/Guardian's Relationship to Child | ||
| Mother | Checkbox |
Check this box if your relationship to the child is Mother.
|
| Father | Checkbox |
Check this box if your relationship to the child is Father.
|
| Guardian | Checkbox |
Check this box if your relationship to the child is Guardian.
|
| Step parent | Checkbox |
Check this box if your relationship to the child is Step parent.
|
| Permission for Child to Return Home | ||
| Next Question Number | Text |
Please enter the number of the next question to proceed to if you will not allow your child to return home to live.
|
| No | Checkbox |
Check this box if you will not allow your child to return home to live.
|
| Yes | Checkbox |
Check this box if you will allow your child to return home to live.
|
| Preferred Spoken Language | ||
| Preferred Spoken Language | Text |
Please enter your preferred spoken language.
|
| Previous Departure Notes | ||
| Previous Departure Note | Text |
Provide a brief note regarding your child's previous departure from home, if applicable. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Problem Duration | ||
| Problem Duration | Text |
Please indicate how long the problems have been ongoing. Fill only if 'No' is 'Yes'.
Depends on:
No
|
| Reason for Child Leaving Home | ||
| Incidents and Problems | Text |
Please provide detailed information and examples regarding the incidents or problems that led your child to leave home. Fill only if 'No' is 'Yes'.
Depends on:
No
|
| Reason for Not Allowing Child to Return Home | ||
| Reason for Not Allowing Child to Return Home | Text |
Provide a detailed explanation of why you will not allow your child to return home to live. Fill only if 'No' is 'No'.
Depends on:
No
|
| Reason For Not Sorting Out Differences | ||
| Explanation for not sorting differences | Text |
Provide a detailed explanation for why you and/or your child have not tried to sort out your differences. Fill only if 'No' is 'Yes'.
Depends on:
No
|
| Relationship Change Description | ||
| Relationship Change Description | Text |
Provide a detailed account of how your relationship with your child has changed since they left home. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Relationship Description | ||
| Relationship Description | Text |
Provide a detailed description of the relationship between your child and their other parent, including how they interact and the nature of their contact. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Second Help Attempt Details | ||
| Details of Second Help Attempt | Text |
Provide a detailed description of what has been tried in this second help attempt. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Name of Contacted Person/Organisation | Text |
Enter the name of the person or organization contacted for this second help attempt. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Duration of Contact | Text |
Specify how long you have had contact with this person or organization for this second help attempt. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Frequency of Contact | Text |
Describe how often you have had contact with this person or organization for this second help attempt. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| No | Checkbox |
Check this box if going to this person or organization did not help improve your relationship. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Yes | Checkbox |
Check this box if going to this person or organization helped improve your relationship. Fill only if 'Does your child currently live with you?' is 'No'.
Depends on:
No
|
| Second Previous Departure Dates | ||
| Second Child Left Home Date | Date |
Enter the second date your child left home, or an estimated date. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Second Child Returned Home Date | Date |
Enter the second date your child returned home to live, or an estimated date. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Silent Number Inquiry for Other Parent/Guardian | ||
| No | Checkbox |
Check this box if the other parent/guardian's home phone number is not a silent number.
|
| Yes | Checkbox |
Check this box if the other parent/guardian's home phone number is a silent number.
|
| Silent Number Inquiry for Parent/Guardian | ||
| No | Checkbox |
Check this box if the Parent/Guardian's home phone number is not a silent number.
|
| Yes | Checkbox |
Check this box if the Parent/Guardian's home phone number is a silent number.
|
| Third Previous Departure Dates | ||
| Third Departure Date | Date |
Provide the date your child left home for the third previous instance, or an estimate of that date. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Third Return Date | Date |
Provide the date your child returned home to live for the third previous instance, or an estimate of that date. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|