Application for Child Support Assessment - Non-parent carer form (CS4121)

Use this form to apply for a new child support assessment for children you are caring for or if you are restarting a previously ended assessment.

Also complete this form if you want to add another child to an existing assessment.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 7 May 2019

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