* Required



Tick the reason below that you are applying an exemption for and check to see which documentation will be required as verification:

CHECKLIST before you SIGN this form:

  • I understand that I can only apply for an exemption for periods of 4 weeks, or until my circumstances change, up to maximum of 2 years.
  • I have ticked the appropriate box and attached the required documents.
  • I understand that I will still receive quarterly accounts as exemptions are granted in arrears, but I will not need to pay the amount.
  • I understand I need update the ETU when my circumstances change ie I find employment, I return to work, I finish workers Comp etc.
  • I will send attachments and proof to [email protected]au