Authority to release personal information - Personal injury, insurance, superannuation or other matter form (SI039)

Use this form to consent to us releasing information about you to a third party.

We will only release personal information about you to a law firm, an insurance company, a superannuation fund, another government agency or other third party organisation, where the information sought can be disclosed under our administrative access scheme.

 

Page last updated: 15 September 2016

This information was printed Thursday 29 September 2016 from humanservices.gov.au/customer/forms/si039 It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.