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.

 
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: 9 April 2018