FER004 Application Centrepay Deduction
FER004 Application Centrepay Deduction
I understand that I can change or cancel my deduction at any time, and further information about
Centrepay can be found online at www.humanservices.gov.au/centrepay. Australian privacy
legislation protects your personal information.
Signature Date 06/04/2024
of
applicant
Completed signed forms can either be emailed to: [email protected] or posted to GPO Box
X2293, PERTH WA 6847.
Important: This is an application only and you should not begin driving until you receive written
confirmation from the Registrar that your application has been approved and your licence suspension
has been lifted. You may also be subject to other restrictions on your licence and you are advised to
check the status of your licence with the Department of Transport.