Form SY042 - Claim for Mobility Allowance Completed Form Examples and Samples
View practical examples of how to fill out Form SY042 - Claim for Mobility Allowance. See a completed sample and learn how to accurately provide your details for a successful application.
Example: Filling Form SY042 - Claim for Mobility Allowance
How this form was filled:
This example demonstrates how our AI processes unstructured text from a personal case note and automatically populates the SY042 Claim for Mobility Allowance. By intelligently extracting demographic data, employment status, and residential history from the provided narrative, the system minimizes manual data entry, reduces errors, and streamlines the application process.
Source document used: Applicant Personal Case Summary
To whom it may concern at the Department of Human Services, I am writing to support my application for the Mobility Allowance. My name is Mr. John Alexander Smith, born on the 15th of May 1985. I currently reside at 42 Maple Street, Springvale, VIC 3171, and my postal address is the same. I am an Australian citizen born in Australia, and I have never traveled outside the country. I do not require an interpreter as English is my primary language. Regarding my employment, I have been working part-time at 'Coastal Logistics' located at 10 Industrial Way, Port Melbourne, VIC 3207, since the 10th of February 2026. My phone number there is (03) 9876 5432 and their ABN is 12 345 678 901. I work approximately 20 hours every two weeks, which totals 40 hours over a four-week period. I am earning the standard minimum wage and this role is expected to continue for more than six months. I also want to mention that I am not receiving any NDIS support, and I have never been given a vehicle under the Vehicle Assistance Scheme. For payment, please use my account at the Commonwealth Bank: BSB 063-123, Account 12345678, held in the name of J.A. Smith. I have attached my identity documents and my recent payslips as proof of my vocational efforts. I hereby declare that all information provided is true and correct as of today, the 12th of March 2026.
Information used to fill out the document:
- Applicant Name: Mr. John Alexander Smith
- Date of Birth: 15/05/1985
- Residential Address: 42 Maple Street, Springvale, VIC 3171
- Employment: Coastal Logistics, 20 hours per fortnight
- Bank Details: Commonwealth Bank, BSB 063-123, Acc 12345678
- Citizenship Status: Australian Citizen (born in Australia)
- Declaration Date: 12/03/2026
What this filled form sample shows:
- Contextual entity extraction from narrative prose
- Handling of Australian-specific form terminology
- Intelligent mapping of unstructured address and bank details
- Automated boolean logic for NDIS and Vehicle Assistance scheme questions
Form specifications and details:
| Form: | SY042 - Claim for Mobility Allowance |
| Target Audience: | Applicants with disabilities in training or employment |
| Complexity: | High (multi-page, conditional logic fields) |
| Industry: | Government / Social Services |
| Categories: | VA claim forms |
| Created: | May 19, 2026 05:58 PM |