Centrelink EServices Confirmation Form

Guardian has streamlining the process for claiming concession. The use of the below authority will alleviate the need for participants to provide income statements and copies of cards to validate their eligibility at each service.  Any client not wishing to provide this authority will need to provide an income statement and copy of card to Guardian Interlock Systems Head Office at least 48 hours prior to every service.

Participants are requested to note that the wording of the Centrelink approval below was dictated by Centrelink and appears to indicate that Guardian seeks access to all of the individual’s record. Guardian only seeks to validate the card and rate of payment, and does not see any other details. Guardian seeks your approval so as to provide a smoother service for you.

I understand by submitting this form I authorise Guardian Interlock Systems Australasia Pty Limited to use Centrelink Confirmation eServices to perform a Centrelink/DVA enquiry of my Centrelink or Department of Veterans’ Affairs customer details and concession card status in order to enable the business to determine if I qualify for a concession rebate.

I also give consent for the Australian Government Department of Human Services (the department) to provide the results of that enquiry to Guardian Interlock Systems Australasia Pty Limited.

I understand that the department will use information I have provided to Guardian Interlock  to confirm my eligibility for concession on interlock services and will disclose to Guardian Interlock Systems Australasia Pty Limited personal information including my Name, DOB, Address, Concession Card status, Receipt of maximum rate of income support (Centrelink only) and Disability rate (DVA customers only).

I understand this consent, once completed and submitted, remains valid while I am a customer of Guardian Interlock Systems Australasia Pty Limited unless I revoke it by contacting Guardian Interlock or the department.

Alternatively, I understand that I can get proof of my circumstances/details from the department and provide it to Guardian Interlock so that my eligibility for a concession on Interlock services provided by Guardian Interlock Systems Australasia Pty Limited can be determined.

I understand that if I withdraw my consent or do not alternatively provide proof of my circumstances/details, I may not be eligible for any concession rate provided by Guardian Interlock.

Centrelink eServices Confirmation Form
Expiry Date of Concession Card
Click or drag files to this area to upload. You can upload up to 3 files.
Insert a photo of your concession card.