This form contains 52 fields organized into 13 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Authorisation Consent
No Checkbox
Check this box if you do not want to authorise a person or organisation to make enquiries or updates, act, or get payments on your behalf.
Yes Checkbox
Check this box if you want to authorise a person or organisation to make enquiries or updates, act, or get payments on your behalf.
Contact Details
Home Phone Number Text
Please provide your home phone number, including the area code.
Max length: 10 characters
Mobile Phone Number Text
Please provide your mobile phone number.
Max length: 10 characters
Work Phone Number Text
Please provide your work phone number, including the area code.
Max length: 10 characters
Alternative Phone Number Text
Please provide an alternative phone number, including the area code.
Max length: 10 characters
Email Address Text
Please provide your email address.
Date of Decision
Decision Day Number
Please enter the day of the decision as a two-digit number.
Max length: 2 characters
Decision Month Number
Please enter the month of the decision as a two-digit number.
Max length: 2 characters
Decision Year Number
Please enter the year of the decision as a four-digit number.
Max length: 4 characters
Decision for Review
ABSTUDY/AIC eligibility Checkbox
Check this box if the decision you want explained or formally reviewed is related to ABSTUDY/AIC eligibility.
Overpayment/debt recovery Checkbox
Check this box if the decision you want explained or formally reviewed is related to overpayment or debt recovery.
Other Checkbox
Check this box if the decision you want explained or formally reviewed is not ABSTUDY/AIC eligibility or overpayment/debt recovery, and then provide details in the space below.
Other Decision Type Text
Please specify the type of decision you want explained or formally reviewed if it is not ABSTUDY/AIC eligibility or Overpayment/debt recovery. Fill only if 'Other' is 'Yes'.
Depends on: Other
Decision Details Text
Provide a detailed explanation about the decision you want to have reviewed or formally explained. Fill only if 'Other' is 'Yes'.
Depends on: Other
Declaration
I have read, understood and agree to the above Checkbox
Check this box to confirm that you have read, understood, and agree to the declaration, acknowledging that the information provided is complete and correct and understanding that giving false or misleading information is a serious offence.
Declaration Day Text
Enter the day the declaration is being made.
Max length: 2 characters
Declaration Month Text
Enter the month the declaration is being made.
Max length: 2 characters
Declaration Year Text
Enter the year the declaration is being made.
Max length: 4 characters
Signature Text
Provide your signature if returning the form by post or in person.
General
Instructions Button
Instructions Button
Q6.Address.0 Text
Q6.Address.1 Text
Q12 Text
Max length: 1 characters
Clear Button
Permanent Address
Address Line 1 Text
Please enter the first line of your permanent street address.
Address Line 2 Text
Please enter the second line of your permanent street address.
Suburb/Town Text
Please enter the suburb, town, or city of your permanent address.
Postcode Text
Please enter the postcode of your permanent address.
Max length: 4 characters
Postal Address
Postal Address Line 1 Text
Enter the first line of the postal address.
Suburb/Town/City Text
Enter the suburb, town, or city for the postal address.
Postcode Number
Enter the postcode for the postal address.
Max length: 4 characters
Reason for Review
Reason for Formal Review Text
Provide a detailed explanation of why you are requesting an explanation or applying for a formal review.
Request Type
An explanation of decision Checkbox
Check this box if you are requesting an explanation of a decision.
A formal review of decision Checkbox
Check this box if you are requesting a formal review of a decision.
Student's Customer Reference Number
Student Customer Reference Number Part 1 Text
Please enter the first segment of the student's customer reference number.
Max length: 3 characters
Student Customer Reference Number Part 2 Text
Please enter the second segment of the student's customer reference number.
Max length: 3 characters
Student Customer Reference Number Part 3 Text
Please enter the third segment of the student's customer reference number.
Max length: 3 characters
Student Customer Reference Number Part 4 Text
Please enter the fourth segment of the student's customer reference number.
Max length: 1 characters
Student's Date of Birth
Day of Birth Text
Enter the day of the student's birth.
Max length: 2 characters
Month of Birth Text
Enter the month of the student's birth.
Max length: 2 characters
Year of Birth Text
Enter the year of the student's birth.
Max length: 4 characters
Student's Full Name
Mr Checkbox
Check this box if the student's title is Mr.
Mrs Checkbox
Check this box if the student's title is Mrs.
Miss Checkbox
Check this box if the student's title is Miss.
Ms Checkbox
Check this box if the student's title is Ms.
Mx Checkbox
Check this box if the student's title is Mx.
Other Title Text
Provide a custom title if 'Mr', 'Mrs', 'Miss', 'Ms', or 'Mx' do not apply. Fill only if 'Mx' is 'Yes'.
Depends on: Mx
Family Name Text
Provide the student's family name or surname.
First Given Name Text
Provide the student's first given name.
Second Given Name Text
Provide the student's second given name, if applicable.