This form contains 247 fields organized into 63 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Additional Care Arrangement Details
Additional Care Arrangements or Concerns Text
Please provide any additional information about your care arrangements or any concerns you may have, such as difficulties contacting the other parent, carer, or guardian. Fill only if 'No', 'Yes' is checked and you have concerns, any.
Depends on: No, Yes
Additional Child in Care Status
No Checkbox
Check this box if you do not have another child in your care who spends time with someone other than your current partner.
Child's Carer Name Text
Enter the full name of the person who cares for the child when they are not with you.
Yes Checkbox
Check this box if you have another child in your care who spends time with someone other than your current partner.
Additional Child Query
No Checkbox
Check this box if you do not have another child in your care who spends time with someone other than your current partner. Fill only if 'Another child' is 'Yes'.
Depends on: DummyCalcQ23.1
Yes Checkbox
Check this box if you have another child in your care who spends time with someone other than your current partner, and you need to provide details for each additional child. Fill only if 'Another child' is 'Yes'.
Depends on: DummyCalcQ23.1
Alternate Caregiver Contact Information
Alternate Caregiver Name Text
Please provide the full name of the alternate caregiver. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Alternate Caregiver Address Line 1 Text
Please enter the first line of the alternate caregiver's street address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Alternate Caregiver Address Line 2 Text
Please enter the second line of the alternate caregiver's street address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Alternate Caregiver Address Line 3 Text
Please enter the third line of the alternate caregiver's street address, such as the suburb or city. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Alternate Caregiver Postcode Text
Please enter the postcode for the alternate caregiver's address. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Alternate Caregiver Phone Number Text
Please provide the phone number, including the area code, for the alternate caregiver. Fill only if 'Yes' is 'Yes'.
Max length: 10 characters
Depends on: Yes
Arrangement Following Status
No Checkbox
Check this box if the arrangements in the parenting plan, court order, or written agreement are NOT being followed.
Yes Checkbox
Check this box if the arrangements in the parenting plan, court order, or written agreement ARE being followed.
Question Number for No Text
Please enter the number of the question to proceed to if the arrangements are not being followed.
Care Arrangement Agreement
No Checkbox
Check this box if the care arrangements stated in this form are NOT agreed between all parties providing care for the children.
Yes Checkbox
Check this box if the care arrangements stated in this form ARE agreed between all parties providing care for the children.
Care Arrangement Dates
Care Arrangement Start Day Text
Provide the day the current care arrangement started.
Max length: 2 characters
Care Arrangement Start Month Text
Provide the month the current care arrangement started.
Max length: 2 characters
Care Arrangement Start Year Text
Provide the year the current care arrangement started.
Max length: 4 characters
Care Arrangement End/Change Day Text
Provide the day the care arrangement is expected to end or change, if applicable. Fill only if 'No' is 'Yes'.
Max length: 2 characters
Depends on: No
Care Arrangement End/Change Month Text
Provide the month the care arrangement is expected to end or change, if applicable. Fill only if 'No' is 'Yes'.
Max length: 2 characters
Depends on: No
Care Arrangement End/Change Year Text
Provide the year the care arrangement is expected to end or change, if applicable. Fill only if 'No' is 'Yes'.
Max length: 4 characters
Depends on: No
Care Arrangement End/Change Date
End/Change Date Day Date
Enter the day these care arrangements are expected to end or change.
Max length: 2 characters
End/Change Date Month Date
Enter the month these care arrangements are expected to end or change.
Max length: 2 characters
End/Change Date Year Date
Enter the year these care arrangements are expected to end or change.
Max length: 4 characters
Care Arrangement Start Date
Day Care Started Date
Please enter the day the care arrangement started.
Max length: 2 characters
Month Care Started Date
Please enter the month the care arrangement started.
Max length: 2 characters
Year Care Started Date
Please enter the year the care arrangement started.
Max length: 4 characters
Care Arrangement Status
No Checkbox
Check this box if your care arrangements are not indefinite or ongoing.
Yes Checkbox
Check this box if your care arrangements are indefinite and ongoing.
Care Arrangements Status
No Checkbox
Check this box if your care arrangements are not indefinite or ongoing.
Yes Checkbox
Check this box if your care arrangements are indefinite or ongoing.
Child Time Spent With Others Status
No Checkbox
Check this box if the child does not spend time with someone other than you or your current partner.
DummyCalcQ25.0 Text
Yes Checkbox
Check this box if the child spends time with someone other than you or your current partner, such as another parent, carer, or guardian.
Child's Date of Birth
Child's Date of Birth - Day Text
Enter the day of the child's birth.
Max length: 2 characters
Child's Date of Birth - Month Text
Enter the month of the child's birth.
Max length: 2 characters
Child's Date of Birth - Year Text
Enter the year of the child's birth.
Max length: 4 characters
Child's Day of Birth Date
Please enter the day of the child's birth.
Max length: 2 characters
Child's Month of Birth Date
Please enter the month of the child's birth.
Max length: 2 characters
Child's Year of Birth Date
Please enter the year of the child's birth.
Max length: 4 characters
Child's Name
Child's Family Name Text
Please provide the child's family name.
Child's Given Name(s) Text
Please provide the child's given name(s).
Child's Family Name Text
Please provide the child's family name.
Child's Given Name(s) Text
Please provide the child's given name(s).
Child's Time with Other Parent/Carer
Nights Text
Provide the total number of nights the child will be with the other parent, carer, or guardian. Fill only if 'question 22' is not empty
Max length: 3 characters
Depends on: No, Yes, Day Care Started, Month Care Started, Year Care Started, End/Change Date Day, End/Change Date Month, End/Change Date Year
Weeks Text
Provide the total number of weeks the child will be with the other parent, carer, or guardian. Fill only if 'question 22' is not empty
Max length: 3 characters
Depends on: No, Yes, Day Care Started, Month Care Started, Year Care Started, End/Change Date Day, End/Change Date Month, End/Change Date Year
Hours Text
Provide the total number of hours the child will be with the other parent, carer, or guardian. Fill only if 'question 22' is not empty
Max length: 3 characters
Depends on: No, Yes, Day Care Started, Month Care Started, Year Care Started, End/Change Date Day, End/Change Date Month, End/Change Date Year
Child's Time with Others
No Checkbox
Check this box if the child does not spend time with anyone other than yourself or your current partner. Fill only if 'Another child' is 'Yes'.
Depends on: DummyCalcQ23.1
Yes Checkbox
Check this box if the child spends time with someone other than yourself or your current partner, such as another parent. Fill only if 'Another child' is 'Yes'.
Depends on: DummyCalcQ23.1
Child's Time with You
Total number of nights with you Number
Enter the total number of nights the child will be with you during the specified care period. Fill only if 'No' is 'Yes'.
Max length: 3 characters
Depends on: No
Total number of weeks with you Number
Enter the total number of weeks the child will be with you during the specified care period. Fill only if 'No' is 'Yes'.
Max length: 3 characters
Depends on: No
Total number of hours with you Number
Enter the total number of hours the child will be with you during the specified care period. Fill only if 'No' is 'Yes'.
Max length: 3 characters
Depends on: No
Contact Details
Home Phone Number Text
Please enter your home phone number, including the area code.
Max length: 10 characters
Mobile Phone Number Text
Please enter your mobile phone number.
Max length: 10 characters
Work Phone Number Text
Please enter your work phone number, including the area code.
Max length: 10 characters
Email Text
Please enter your email address.
Contact Person Details
Full name Text
Depends on: Yes
Q25_Details_1.Address1 Text
Depends on: Yes
Q25_Details_1.Address2 Text
Depends on: Yes
Q25_Details_1.Address3 Text
Depends on: Yes
Q25_Details_1.Postcode Text
Max length: 4 characters
Depends on: Yes
Enter 10 digit number with no spaces. Include area code for a landline Text
Max length: 10 characters
Depends on: Yes
Current Payments Status
No Checkbox
Check this box if you and/or your partner are NOT currently receiving fortnightly payments, including a zero rate of Family Tax Benefit or Child Care Subsidy for this child.
Yes Checkbox
Check this box if you and/or your partner ARE currently receiving fortnightly payments, including a zero rate of Family Tax Benefit or Child Care Subsidy for this child.
Go To Question Number Text
Please provide the number of the next question to proceed to if you are not currently receiving fortnightly payments.
Customer Reference Number
Reference Number Part 1 Text
Enter the first part of your customer reference number.
Max length: 3 characters
Reference Number Part 2 Text
Enter the second part of your customer reference number.
Max length: 3 characters
Reference Number Part 3 Text
Enter the third part of your customer reference number.
Max length: 3 characters
Reference Number Part 4 Text
Enter the fourth part of your customer reference number.
Max length: 1 characters
Date Married or Last Reconciled
Day of Marriage/Reconciliation Text
Enter the day you were married or last reconciled with your partner.
Month of Marriage/Reconciliation Text
Enter the month you were married or last reconciled with your partner. Fill only if 'Married' is 'Yes'.
Max length: 2 characters
Depends on: Married
First Two Digits of Year Text
Enter the first two digits of the year you were married or last reconciled with your partner. Fill only if 'Married' is 'Yes'.
Max length: 2 characters
Depends on: Married
Last Two Digits of Year Text
Enter the last two digits of the year you were married or last reconciled with your partner. Fill only if 'Married' is 'Yes'.
Max length: 4 characters
Depends on: Married
Date of Birth
Day of Birth Text
Please enter the day of your birth.
Max length: 2 characters
Month of Birth Text
Please enter the month of your birth.
Max length: 2 characters
Year of Birth Number
Please enter the year of your birth.
Max length: 4 characters
Date of Divorce
Divorce Day Date
Please provide the day of the divorce. Fill only if 'Divorced' is 'Yes'.
Max length: 2 characters
Depends on: Divorced
Divorce Month Date
Please provide the month of the divorce. Fill only if 'Divorced' is 'Yes'.
Max length: 2 characters
Depends on: Divorced
Divorce Year Date
Please provide the year of the divorce. Fill only if 'Divorced' is 'Yes'.
Max length: 4 characters
Depends on: Divorced
Date of Last Separation
Day of Last Separation Text
Please enter the day of your last separation. Fill only if 'Separated' is 'Yes'.
Max length: 2 characters
Depends on: Separated
Month of Last Separation Text
Please enter the month of your last separation. Fill only if 'Separated' is 'Yes'.
Max length: 2 characters
Depends on: Separated
Year of Last Separation Text
Please enter the year of your last separation. Fill only if 'Separated' is 'Yes'.
Max length: 4 characters
Depends on: Separated
Date of Partner's Death
Day of partner's death Text
Enter the day of your partner's death. Fill only if 'Widowed' is 'Yes'.
Max length: 2 characters
Depends on: Widowed
Month of partner's death Text
Enter the month of your partner's death. Fill only if 'Widowed' is 'Yes'.
Max length: 2 characters
Depends on: Widowed
Year of partner's death Text
Enter the year of your partner's death. Fill only if 'Widowed' is 'Yes'.
Max length: 4 characters
Depends on: Widowed
Date Registered or Last Reconciled
Registered Relationship Day Number
Please enter the day your registered relationship was registered or last reconciled. Fill only if 'Registered relationship' is 'Yes'.
Max length: 2 characters
Depends on: Registered relationship
Registered Relationship Month Number
Please enter the month your registered relationship was registered or last reconciled. Fill only if 'Registered relationship' is 'Yes'.
Max length: 2 characters
Depends on: Registered relationship
Registered Relationship Year Number
Please enter the year your registered relationship was registered or last reconciled. Fill only if 'Registered relationship' is 'Yes'.
Max length: 4 characters
Depends on: Registered relationship
Date Relationship Started or Last Reconciled
De facto Relationship Day Date
Please provide the day you started your de facto relationship or last reconciled with your partner. Fill only if 'De facto' is 'Yes'.
Max length: 2 characters
Depends on: De facto
De facto Relationship Month Date
Please provide the month you started your de facto relationship or last reconciled with your partner. Fill only if 'De facto' is 'Yes'.
Max length: 2 characters
Depends on: De facto
De facto Relationship Year Date
Please provide the year you started your de facto relationship or last reconciled with your partner. Fill only if 'De facto' is 'Yes'.
Max length: 4 characters
Depends on: De facto
Declarant's Signature and Date
Sign Text
Declaration Date Day Text
Please enter the day of the date you are signing this declaration.
Max length: 2 characters
Declaration Date Month Text
Please enter the month of the date you are signing this declaration.
Max length: 2 characters
Declaration Date Year Text
Please enter the year of the date you are signing this declaration.
Max length: 4 characters
Declarant's Signature Text
Please enter your full legal signature to confirm your declaration.
Duration of Care With Other Parent
Number of Nights Number
Enter the total number of nights this child will be with the other parent, carer, or guardian for the specified care period. Fill only if 'Another child' is 'Yes'.
Max length: 3 characters
Depends on: DummyCalcQ23.1
Number of Weeks Number
Enter the total number of weeks this child will be with the other parent, carer, or guardian for the specified care period. Fill only if 'Another child' is 'Yes'.
Max length: 3 characters
Depends on: DummyCalcQ23.1
Number of Hours Number
Enter the total number of hours this child will be with the other parent, carer, or guardian for the specified care period. Fill only if 'Another child' is 'Yes'.
Max length: 3 characters
Depends on: DummyCalcQ23.1
Duration of Care With You
Total Nights Text
Enter the total number of nights the child will be with you during the care period. Fill only if 'No' is 'No'.
Max length: 3 characters
Depends on: No
Total Weeks Text
Enter the total number of weeks the child will be with you during the care period. Fill only if 'No' is 'No'.
Max length: 3 characters
Depends on: No
Total Hours Text
Enter the total number of hours the child will be with you during the care period. Fill only if 'No' is 'No'.
Max length: 3 characters
Depends on: No
Family Tax Benefit Eligibility Question
No Checkbox
Check this box if you do not want to test your eligibility for Family Tax Benefit or Child Care Subsidy for this child and wish to proceed to the next question. Fill only if 'No' is 'Yes'.
Depends on: No
Yes Checkbox
Check this box if you want to test your eligibility for Family Tax Benefit or Child Care Subsidy for this child and will continue to complete and return this form. Fill only if 'No' is 'Yes'.
Depends on: No
Family Tax Benefit Eligibility Test
No Checkbox
Check this box if you do not want to test your eligibility for Family Tax Benefit or Child Care Subsidy for this child and wish to proceed to the next question.
Yes Checkbox
Check this box if you want to test your eligibility for Family Tax Benefit or Child Care Subsidy for this child, or if you are not currently receiving these benefits and wish to make a claim.
Fortnightly Payments Question
No Checkbox
Check this box if you and/or your partner are NOT currently receiving fortnightly payments, including receiving a zero rate of Family Tax Benefit or receiving Child Care Subsidy for this child.
Yes Checkbox
Check this box if you and/or your partner ARE currently receiving fortnightly payments, including receiving a zero rate of Family Tax Benefit or receiving Child Care Subsidy for this child.
Next Question Number for No Text
Provide the number of the next question to proceed to if you are not currently receiving fortnightly payments for this child.
Further Care Arrangement Information
Further Care Arrangement Details Text
Please provide any additional information regarding the care arrangements for this child, such as specific schedules or holiday arrangements.
Further Information on Care Arrangements
Further Information Text
Please provide any further details regarding the care arrangements for this child. Fill only if 'Another child' is 'Yes'.
Depends on: DummyCalcQ23.1
General
Instructions Button
Instructions Button
Q4.Address1 Text
Q4.Address2 Text
Q5.Address1 Text
Q5.Address2 Text
Q7GoToQ8_0 Button
Q7GoToQ8_1 Button
Q7GoToQ8_2 Button
Q7GoToQ14_0 Button
Q7GoToQ14_1 Button
Q7GoToQ14_2 Button
Q7GoToQ14_3 Button
14 Text
Max length: 1 characters
Q19GoToQ21.0 Button
Q23GoToQ25.0 Button
Q24GoToQ32.0 Button
Q25GoToQ32.0 Button
Q26GoToQ29.0 Button
Q28GoToQ32_0 Button
Q32GoToQ33.0 Button
Q19GoToQ21.1 Button
Q23GoToQ25.1 Button
Q24GoToQ32.1 Button
Q25GoToQ32.1 Button
Q26GoToQ29.1 Button
Q28GoToQ32.1 Button
Q35 Text
Max length: 1 characters
Clear button Button
Knowledge of Care Percentage
No Checkbox
Check this box if you do not know the percentage of care you will have for the care period stated in question 22. Fill only if 'Another child' is 'Yes'.
Depends on: DummyCalcQ23.1
Yes Checkbox
Check this box if you know the percentage of care you will have for the care period stated in question 22. Fill only if 'Another child' is 'Yes'.
Depends on: DummyCalcQ23.1
Knowledge of Care Percentage Status
No Checkbox
Check this box if you do not know what percentage of care you will have for the care period stated in question 22. Fill only if 'question 22' is not empty
Depends on: No, Yes, Day Care Started, Month Care Started, Year Care Started, End/Change Date Day, End/Change Date Month, End/Change Date Year
Care Percentage Calculation Number
Provide the percentage of care you will have for the child during the specified care period, as calculated using the provided guidance. Fill only if 'question 22' is not empty
Depends on: No, Yes, Day Care Started, Month Care Started, Year Care Started, End/Change Date Day, End/Change Date Month, End/Change Date Year
Yes Checkbox
Check this box if you know what percentage of care you will have for the care period stated in question 22. Fill only if 'question 22' is not empty
Depends on: No, Yes, Day Care Started, Month Care Started, Year Care Started, End/Change Date Day, End/Change Date Month, End/Change Date Year
Office Hours Contact Phone Number
Office Hours Contact Phone Number Text
Please provide your best office hours contact phone number, including the area code, for verification of your agreement to the care arrangements. Fill only if 'question 33' is 'Yes'
Max length: 10 characters
Depends on: Yes
Other Carer's Name
Other Carer's Name Text
Provide the full name of the other carer. Fill only if 'question 33' is 'Yes'
Depends on: Yes
Other Parent's Care Percentage
Other Parent Care Percentage Number
Enter the percentage of care the other parent, carer, or guardian of this child will have during the care period stated in question 22. Fill only if 'question 22' is not empty
Depends on: No, Yes, Day Care Started, Month Care Started, Year Care Started, End/Change Date Day, End/Change Date Month, End/Change Date Year
Q28.1 Text
Depends on: Yes
Parenting Arrangement Compliance
No, arrangements not followed Checkbox
Check this box if the arrangements in the parenting plan, court order, or written agreement are not being followed for Child 2. Fill only if 'Another child' is 'Yes'.
Depends on: DummyCalcQ23.1
Yes, arrangements followed Checkbox
Check this box if the arrangements in the parenting plan, court order, or written agreement are being followed for Child 2. Fill only if 'Another child' is 'Yes'.
Depends on: DummyCalcQ23.1
Next Question Number (If Not Followed) Text
Please specify the number of the next question to proceed to if the parenting arrangements are not being followed. Fill only if 'No, arrangements not followed' is 'No'.
Depends on: No, arrangements not followed
Parenting Plan Agreement
No Checkbox
Check this box if you do not have a parenting plan, court order, or written agreement that shows where this child stays.
Child's Family Name Text
Please enter the child's family name as it appears on official documents.
Yes Checkbox
Check this box if you have a parenting plan, court order, or written agreement that shows where this child stays.
Parenting Plan Question
No Checkbox
Check this box if you do not have a parenting plan, court order, or written agreement that shows where this child stays.
DummyCalcQ23.1 Text
Yes Checkbox
Check this box if you have a parenting plan, court order, or written agreement that shows where this child stays.
Partner's Contact Details
Partner's Home Phone Number Text
Please enter your partner's home phone number, including the area code. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Max length: 10 characters
Depends on: Married, Registered relationship, De facto
Partner's Mobile Phone Number Text
Please enter your partner's mobile phone number. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Max length: 10 characters
Depends on: Married, Registered relationship, De facto
Partner's Work Phone Number Text
Please enter your partner's work phone number, including the area code. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Max length: 10 characters
Depends on: Married, Registered relationship, De facto
Partner's Email Text
Please enter your partner's email address. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Partner's Customer Reference Number
Customer Reference Number (CRN) Text
Max length: 3 characters
Depends on: Married, Registered relationship, De facto
Customer Reference Number (CRN) Text
Max length: 3 characters
Depends on: Married, Registered relationship, De facto
Customer Reference Number (CRN) Text
Max length: 3 characters
Depends on: Married, Registered relationship, De facto
Customer Reference Number (CRN) Text
Max length: 1 characters
Depends on: Married, Registered relationship, De facto
Partner's Date of Birth
Partner's Day of Birth Date
Provide the day of your partner's birth. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Max length: 2 characters
Depends on: Married, Registered relationship, De facto
Partner's Month of Birth Date
Provide the month of your partner's birth. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Max length: 2 characters
Depends on: Married, Registered relationship, De facto
Partner's Year of Birth Date
Provide the year of your partner's birth. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Max length: 4 characters
Depends on: Married, Registered relationship, De facto
Partner's Name
Mr Checkbox
Check this box if your partner's title is Mr. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Mrs Checkbox
Check this box if your partner's title is Mrs. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Miss Checkbox
Check this box if your partner's title is Miss. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Ms Checkbox
Check this box if your partner's title is Ms. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Mx Checkbox
Check this box if your partner's title is Mx. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Partner's Other Title Text
Enter your partner's custom title if their preferred title is not listed. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Partner's Family Name Text
Provide your partner's family name or surname. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Partner's First Given Name Text
Provide your partner's first given name. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Partner's Second Given Name Text
Provide your partner's second given name. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Partner's Permanent Address
Address Line 1 Text
Enter the first line of your partner's permanent address. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Address Line 2 Text
Enter the second line of your partner's permanent address. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Suburb/Town/State Text
Enter the suburb, town, or state of your partner's permanent address. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Postcode Text
Enter the postcode for your partner's permanent address. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Max length: 4 characters
Depends on: Married, Registered relationship, De facto
Partner's Relationship to Child
Parent Checkbox
Check this box if your partner is a natural or relationship parent to the child.
Adoptive parent Checkbox
Check this box if your partner is an adoptive parent to the child.
Grandparent Checkbox
Check this box if your partner is a grandparent to the child.
Step-parent Checkbox
Check this box if your partner is a step-parent to the child.
Foster carer Checkbox
Check this box if your partner is a foster carer for the child.
Other Checkbox
Check this box if your partner's relationship to the child is not one of the listed options and provide details in the space below.
Partner's Other Relationship Text
Enter the specific relationship of your partner to the child if it is not one of the listed options. Fill only if 'Other' is 'Yes'.
Depends on: Other
Partner's Relationship Explanation Text
Provide any further explanation or additional details regarding your partner's relationship to the child.
Partner's Relationship to the Child
Parent Checkbox
Check this box if your partner is the natural or legal parent of the child.
Adoptive parent Checkbox
Check this box if your partner is the adoptive parent of the child.
Grandparent Checkbox
Check this box if your partner is the grandparent of the child.
Step-parent Checkbox
Check this box if your partner is the step-parent of the child.
Foster carer Checkbox
Check this box if your partner is the foster carer of the child.
Other Checkbox
Check this box if your partner's relationship to the child is not listed in the options above.
Partner's Other Relationship Brief Details Text
Enter a brief description of your partner's relationship to the child if it falls under the 'Other' category.
Partner's Other Relationship Extended Details Text
Provide extended details regarding your partner's relationship to the child if it falls under the 'Other' category. Fill only if 'Other' is 'Yes'.
Depends on: Other
Percentage Calculation Information
Care Percentage Number
Enter the percentage of care you will have for the care period stated in question 22. Fill only if 'Another child' is 'Yes'.
Depends on: DummyCalcQ23.1
Permanent Address
Permanent Street Address Text
Please enter your full permanent street address details.
Permanent Suburb/Town Text
Please enter the suburb or town of your permanent address.
Permanent Postcode Text
Please provide the postcode for your permanent address.
Max length: 4 characters
Permission for Partner Enquiries
No Checkbox
Check this box if you do not give permission for your partner to make enquiries on your behalf. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Yes Checkbox
Check this box if you give permission for your partner to make enquiries on your behalf. Fill only if 'Married', 'Registered relationship', 'De facto' is 'Yes', any.
Depends on: Married, Registered relationship, De facto
Postal Address
Postal Address Line 1 Text
Enter the first line of your postal address.
Postal Address Line 2 Text
Enter the second line of your postal address, including suburb or city, if applicable.
Postal Postcode Text
Enter the postcode for your postal address.
Max length: 4 characters
Relationship Status
Married Checkbox
Check this box if you are currently married and are not separated.
Registered relationship Checkbox
Check this box if your relationship is registered under Australian state or territory law and you are not separated.
De facto Checkbox
Check this box if your relationship is similar to a married couple but you are not married or in a registered relationship, and you are not separated.
Separated Checkbox
Check this box if you were previously in a marriage, registered, or de facto relationship and are now separated.
Divorced Checkbox
Check this box if you are legally divorced.
Widowed Checkbox
Check this box if you were previously in a marriage, registered, or de facto relationship and your partner has passed away.
Never married or lived with a partner Checkbox
Check this box if you have never been married or lived with a partner in a de facto or registered relationship.
Shared Care Information
Shared Care Reference Number Text
Please provide the reference number for the shared care information. Fill only if 'Another child' is 'Yes'.
Depends on: DummyCalcQ23.1
Signature Date
Signature Day Date
Please provide the day of the signature. Fill only if 'question 33' is 'Yes'
Max length: 2 characters
Depends on: Yes
Signature Month Date
Please provide the month of the signature. Fill only if 'question 33' is 'Yes'
Max length: 2 characters
Depends on: Yes
Signature Year Date
Please provide the year of the signature. Fill only if 'question 33' is 'Yes'
Max length: 4 characters
Depends on: Yes
Your Care Percentage
Your Care Percentage Number
Enter the percentage of care you will have for this child during the specified care period. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Your Care Percentage Number
Enter the percentage of care you will have during the care period stated in question 22. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Your Name
Q2.Title_Mr CheckBox
Q2.Title_Mrs CheckBox
Q2.Title_Miss CheckBox
Q2.Title_Ms CheckBox
Q2.Title_Mx CheckBox
Other Title Text
Please specify your preferred title if it is not listed among the options. Fill only if 'Q2.Title_Mx' is selected for the 'Other' title.
Depends on: Q2.Title_Mx
Family Name Text
Enter your family name or surname as it appears on your official documents.
First Given Name Text
Enter your first or primary given name as it appears on your official documents.
Second Given Name Text
Enter your second given name, if applicable, as it appears on your official documents.
Your Relationship to Child
Parent Checkbox
Check this box if your relationship to the child is that of a natural parent, or if you are legally responsible for the child due to artificial conception or a surrogacy court order.
Adoptive parent Checkbox
Check this box if your relationship to the child is that of an adoptive parent.
Grandparent Checkbox
Check this box if your relationship to the child is that of a grandparent.
Step-parent Checkbox
Check this box if your relationship to the child is that of a step-parent.
Foster carer Checkbox
Check this box if your relationship to the child is that of a foster carer.
Other Checkbox
Check this box if your relationship to the child is not one of the options listed above, and provide details in the space provided.
Other Relationship Details Text
Enter the details describing your relationship to the child if it is not one of the listed options. Fill only if 'Other' is 'Yes'.
Depends on: Other
Extended Relationship Details (Other) Text
Provide further details if the 'Other' relationship to the child requires additional explanation.
Your Relationship to the Child
Q17_0_Parent CheckBox
Q17_0_Adoptiveparent CheckBox
Q17_0_Grandparent CheckBox
Q17_0_Step-parent CheckBox
Q17_0_FosterCarer CheckBox
Q17_0_Other CheckBox
Other Relationship Text
Please provide the type of your relationship to the child if it is not listed above.
Other Relationship Details Text
Please provide further details regarding your 'Other' relationship to the child. Fill only if 'Q17_0_Other' is 'Yes'.
Depends on: Q17_0_Other