Form SS293, Advice of death Instructions

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This form contains 156 fields organized into 45 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Aboriginal or Torres Strait Islander Descent
No Checkbox
Check this box if the person was not of Aboriginal or Torres Strait Islander Australian descent.
Aboriginal or Torres Strait Islander Descent (No) Text
Enter your response indicating that the person is not of Aboriginal or Torres Strait Islander Australian descent.
Yes - Aboriginal Australian Checkbox
Check this box if the person was of Aboriginal Australian descent.
Yes - Torres Strait Islander Australian Checkbox
Check this box if the person was of Torres Strait Islander Australian descent.
Australian South Sea Islander Descent
No Checkbox
Check this box if the deceased person was not of Australian South Sea Islander descent.
Yes Checkbox
Check this box if the deceased person was of Australian South Sea Islander descent.
Child(ren)'s Current Address
Address Line 1 Text
Please provide the first line of the child(ren)'s current street address.
Address Line 2 Text
Please provide the second line of the child(ren)'s current street address.
Address Line 3 Text
Please provide the third line of the child(ren)'s current street address, which may include suburb, city, and state.
Postcode Text
Please provide the postcode for the child(ren)'s current address.
Max length: 4 characters
Date of Death
Day of Death Date
Please enter the day the person died.
Max length: 2 characters
Month of Death Date
Please enter the month the person died.
Max length: 2 characters
Year of Death Date
Please enter the year the person died.
Max length: 4 characters
Deceased Person Education Qualification
No Checkbox
Check this box if the deceased person was not studying in an approved course leading to Year 12 or an equivalent qualification. Fill only if 'Their date of birth' results in the deceased person's age being between 16 and 20 years
Depends on: Date of Birth Day, Date of Birth Month, Date of Birth Year
Not sure Checkbox
Check this box if you are not sure whether the deceased person was studying in an approved course leading to Year 12 or an equivalent qualification. Fill only if 'Their date of birth' results in the deceased person's age being between 16 and 20 years
Depends on: Date of Birth Day, Date of Birth Month, Date of Birth Year
Yes Checkbox
Check this box if the deceased person was studying in an approved course leading to Year 12 or an equivalent qualification. Fill only if 'Their date of birth' results in the deceased person's age being between 16 and 20 years
Depends on: Date of Birth Day, Date of Birth Month, Date of Birth Year
Deceased Person's Centrelink Reference Number
Centrelink Reference Number Part 1 Text
Please enter the first segment of the deceased person's Centrelink Reference Number.
Max length: 3 characters
Centrelink Reference Number Part 2 Text
Please enter the second segment of the deceased person's Centrelink Reference Number.
Max length: 3 characters
Centrelink Reference Number Part 3 Text
Please enter the third segment of the deceased person's Centrelink Reference Number.
Max length: 3 characters
Centrelink Reference Number Part 4 Text
Please enter the fourth segment of the deceased person's Centrelink Reference Number.
Max length: 1 characters
Deceased Person's Child Support Reference Number
Child Support Reference Number, Segment 1 Text
Please provide the first segment of the deceased person's Child Support Reference Number.
Max length: 3 characters
Child Support Reference Number, Segment 2 Text
Please provide the second segment of the deceased person's Child Support Reference Number.
Max length: 3 characters
Child Support Reference Number, Segment 3 Text
Please provide the third segment of the deceased person's Child Support Reference Number.
Max length: 3 characters
Child Support Reference Number, Segment 4 Text
Please provide the fourth segment of the deceased person's Child Support Reference Number.
Max length: 3 characters
Deceased Person's Child Support Status
No Checkbox
Check this box if the deceased person did not receive child support for a child in their care, and did not pay child support.
DummyCalcQ11 Text
Not sure Checkbox
Check this box if you are not sure whether the deceased person received or paid child support.
Yes Checkbox
Check this box if the deceased person either received child support for a child in their care or paid child support.
Deceased Person's Date of Birth
Date of Birth Day Date
Please provide the day of the deceased person's birth.
Max length: 2 characters
Date of Birth Month Date
Please provide the month of the deceased person's birth.
Max length: 2 characters
Date of Birth Year Date
Please provide the year of the deceased person's birth.
Max length: 4 characters
Deceased Person's Home Address
Address Line 1 Text
Please enter the first line of the deceased person's home address, including the street number and street name.
Address Line 2 Text
Please enter the second line of the deceased person's home address, such as the unit number, building name, or additional street details.
Suburb/Town Text
Please enter the suburb or town for the deceased person's home address.
Postcode Text
Please enter the postcode for the deceased person's home address.
Max length: 4 characters
Deceased Person's Medicare Card Number
Medicare Card Number Part 1 Text
Enter the first part of the deceased person's Medicare card number.
Max length: 4 characters
Medicare Card Number Part 2 Text
Enter the second part of the deceased person's Medicare card number.
Max length: 5 characters
Medicare Card Number Part 3 Text
Enter the third part of the deceased person's Medicare card number.
Max length: 1 characters
Medicare Card Reference Number Text
Enter the deceased person's single-digit Medicare card reference number.
Max length: 1 characters
Deceased Person's Name
Deceased Family Name Text
Please provide the family name of the deceased person.
Deceased First Given Name Text
Please provide the first given name of the deceased person.
Deceased Second Given Name Text
Please provide the second given name of the deceased person.
Deceased Person's Relationship Status
Single Checkbox
Check this box if the deceased person was single at the time of their death.
Partnered Checkbox
Check this box if the deceased person was in a partnership at the time of their death.
Not sure Checkbox
Check this box if you are unsure of the deceased person's relationship status at the time of their death.
Deceased Person's Title
Title1_Mr CheckBox
Mrs Checkbox
Check this box if the deceased person's title is Mrs.
Miss Checkbox
Check this box if the deceased person's title is Miss.
Ms Checkbox
Check this box if the deceased person's title is Ms.
Mx Checkbox
Check this box if the deceased person's title is Mx.
Other Title Text
Please provide the deceased person's title if it is not Mr, Mrs, Miss, Ms, or Mx. Fill only if 'Mx' is not selected. This field is for 'Other' title, which is an alternative to 'Mx' (5) and other titles (1-4)..
Depends on: Mx
Declaration
Full Name Text
Enter your full legal name as it appears on official documents.
Signature Text
Enter your signature to confirm the declaration.
Declaration Day Text
Enter the day of the month when this declaration is made.
Max length: 2 characters
Declaration Month Text
Enter the month when this declaration is made.
Max length: 2 characters
Declaration Year Number
Enter the year when this declaration is made.
Max length: 4 characters
Executor/Administrator Address
Executor/Administrator Address Line 1 Text
Please provide the first line of the executor or administrator's residential or postal address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Executor/Administrator Address Line 2 Text
Please provide the second line of the executor or administrator's residential or postal address, such as the suburb or city. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Executor/Administrator Postcode Text
Please provide the postcode for the executor or administrator's address. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Executor/Administrator Contact Phone Number
Contact Phone Number Text
Please enter the executor's or administrator's contact phone number, including the area code. Fill only if 'Yes' is 'Yes'.
Max length: 10 characters
Depends on: Yes
Executor/Administrator Details Known
Not applicable Checkbox
Check this box if the executor or administrator details are not applicable to the estate.
No Checkbox
Check this box if the executor or administrator details are not known.
Yes Checkbox
Check this box if the executor or administrator details are known.
Executor/Administrator Name
Family Name Text
Please provide the family name of the executor or administrator. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
First Given Name Text
Please provide the first given name of the executor or administrator. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Executor/Administrator Organisation Name
Organisation Name Text
Please provide the name of the organisation for the executor or administrator, if applicable. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Executor/Administrator Title
Mr Checkbox
Check this box if the executor or administrator uses the title 'Mr'. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Mrs Checkbox
Check this box if the executor or administrator uses the title 'Mrs'. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Miss Checkbox
Check this box if the executor or administrator uses the title 'Miss'. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Ms Checkbox
Check this box if the executor or administrator uses the title 'Ms'. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Mx Checkbox
Check this box if the executor or administrator uses the title 'Mx'. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Other Title Text
Please provide the title for the executor or administrator if it is not one of the standard options (Mr, Mrs, Miss, Ms, Mx). Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Funeral Director's Address
Address Line 1 Text
Please enter the first line of the funeral director's address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Address Line 2 Text
Please enter the second line of the funeral director's address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Town/City Text
Please enter the town or city of the funeral director's address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Postcode Text
Please enter the postcode of the funeral director's address. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Funeral Director's Contact Phone Number
Funeral Director's Contact Phone Number Text
Provide the funeral director's contact phone number, including the area code. Fill only if 'Yes' is 'Yes'.
Max length: 10 characters
Depends on: Yes
Funeral Director's Details Known
No Checkbox
Check this box if the funeral director's details are not known.
Yes Checkbox
Check this box if the funeral director's details are known.
Funeral Director's Name
Funeral Director's Name Text
Please provide the full name of the funeral director. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
General
Instructions Button
Instructions Button
Q11GoToQ13a Button
Q11GoToQ13b Button
Q14GoToQ21 Button
Q20GoToQ26 Button
Q26GoToQ31a Button
Q26GoToQ31b Button
DummyCalcQ31 Text
Q31GoToQ37a Button
Q31GoToQ37b Button
Q34.Address1 Text
Q34.Address2 Text
DummyCalcQ37 Text
Q37GoToQ41 Button
Q41 Text
Max length: 1 characters
Clear Button
Hospital Address
Hospital Address Line 1 Text
Enter the first line of the hospital's street address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Hospital Address Line 2 Text
Enter the second line of the hospital's street address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Hospital City/Suburb Text
Enter the city or suburb of the hospital's address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Hospital Postcode Text
Enter the postcode of the hospital's address. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Hospital Contact Name
Contact Name Text
Please provide the full name of the hospital contact. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Hospital Contact Phone Number
Hospital Contact Phone Number Text
Provide the contact phone number for the hospital, including the area code. Fill only if 'Yes' is 'Yes'.
Max length: 10 characters
Depends on: Yes
Hospital Details Availability
Not applicable Checkbox
Check this box if the question regarding hospital details is not relevant or does not apply.
DummyCalcQ26 Text
No Checkbox
Check this box if hospital details are not known.
Yes Checkbox
Check this box if hospital details are known and can be provided.
Hospital Name
Hospital Name Text
Please provide the full name of the hospital. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Information Request from Services Australia
No Checkbox
Check this box if the executor or administrator will not request information from Services Australia. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Not sure Checkbox
Check this box if you are not sure whether the executor or administrator will request information from Services Australia. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Yes Checkbox
Check this box if the executor or administrator will request information from Services Australia. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Notifier's Contact Phone Number
Notifier's Contact Phone Number Text
Please provide the notifier's contact phone number, including the area code.
Max length: 10 characters
Notifier's Name
Mr Checkbox
Check this box if the notifier's title is Mr.
Mrs Checkbox
Check this box if the notifier's title is Mrs.
Miss Checkbox
Check this box if the notifier's title is Miss.
Ms Checkbox
Check this box if the notifier's title is Ms.
Mx Checkbox
Check this box if the notifier's title is Mx.
TitleOther3 Text
Notifier's Family Name Text
Provide the family name of the notifier or next of kin.
Notifier's First Given Name Text
Provide the first given name of the notifier or next of kin.
Notifier's Organisation Name
Organisation Name Text
Please provide the name of the organisation.
Notifier's Postal Address
Address Line 1 Text
Please enter the first line of the notifier's postal address.
Address Line 2 Text
Please enter the second line of the notifier's postal address.
Suburb/City/State Text
Please enter the suburb, city, or state for the notifier's postal address.
Postcode Text
Please enter the postcode for the notifier's postal address.
Max length: 4 characters
Notifier's Relationship to Deceased Person
Relationship to Deceased Person Text
Please enter the notifier's relationship to the deceased person.
Parent Details
Mr Checkbox
Check this box if the parent uses the title Mr. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Mrs Checkbox
Check this box if the parent uses the title Mrs. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Miss Checkbox
Check this box if the parent uses the title Miss. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Ms Checkbox
Check this box if the parent uses the title Ms. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Mx Checkbox
Check this box if the parent uses the title Mx. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Other Title Text
Please provide your title if it is not Mr, Mrs, Miss, Ms, or Mx. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Family Name Text
Please provide your family name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
First Given Name Text
Please provide your first given name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Parent of Deceased Confirmation
No Checkbox
Check this box if you are not a parent of the deceased person.
DummyCalcQ14 Text
Yes Checkbox
Check this box if you are a parent of the deceased person.
Parent's Centrelink Reference Number
Part 1 Text
Please enter the first section of the parent's Centrelink Reference Number. Fill only if 'Yes' is 'Yes'.
Max length: 3 characters
Depends on: Yes
Part 2 Text
Please enter the second section of the parent's Centrelink Reference Number. Fill only if 'Yes' is 'Yes'.
Max length: 3 characters
Depends on: Yes
Part 3 Text
Please enter the third section of the parent's Centrelink Reference Number. Fill only if 'Yes' is 'Yes'.
Max length: 3 characters
Depends on: Yes
Part 4 Text
Please enter the fourth section of the parent's Centrelink Reference Number. Fill only if 'Yes' is 'Yes'.
Max length: 1 characters
Depends on: Yes
Parent's Child Support Reference Number
Child Support Reference Number Part 1 Text
Please enter the first part of the child support reference number. Fill only if 'Yes' is 'Yes'.
Max length: 3 characters
Depends on: Yes
Child Support Reference Number Part 2 Text
Please enter the second part of the child support reference number. Fill only if 'Yes' is 'Yes'.
Max length: 3 characters
Depends on: Yes
Child Support Reference Number Part 3 Text
Please enter the third part of the child support reference number. Fill only if 'Yes' is 'Yes'.
Max length: 3 characters
Depends on: Yes
Child Support Reference Number Part 4 Text
Please enter the fourth part of the child support reference number. Fill only if 'Yes' is 'Yes'.
Max length: 3 characters
Depends on: Yes
Parent's Contact Phone Number
Parent's Phone Number Part Text
Please provide any additional part of the parent's contact phone number, such as an extension or a specific segment of the number.
Parent's Contact Phone Number Text
Please enter the parent's contact phone number, including the area code. Fill only if 'Yes' is 'Yes'.
Max length: 10 characters
Depends on: Yes
Parent's Home Address
Address Line 1 Text
Enter the first line of the parent's home address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Address Line 2 Text
Enter the second line of the parent's home address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Address Line 3 Text
Enter the third line of the parent's home address, which may include suburb, city, or state. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Postcode Text
Enter the postcode for the parent's home address. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Parent's Medicare Card Number
Medicare Card Number Part 1 Text
Enter the first part of the parent's Medicare card number. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Medicare Card Number Part 2 Text
Enter the second part of the parent's Medicare card number. Fill only if 'Yes' is 'Yes'.
Max length: 5 characters
Depends on: Yes
Medicare Card Number Part 3 Text
Enter the third part of the parent's Medicare card number. Fill only if 'Yes' is 'Yes'.
Max length: 1 characters
Depends on: Yes
Medicare Card Reference Number Text
Enter the individual reference number from the parent's Medicare card. Fill only if 'Yes' is 'Yes'.
Max length: 1 characters
Depends on: Yes
Partner's Name
Partner's Name Text
Please enter the full name of the partner, if applicable. Fill only if 'Partnered' is 'Yes'.
Depends on: Partnered