Income and Assets form (MOD IA)
Use this form to provide information about any additional income and assets you have.
Download and complete the Income and Assets form.
If you are claiming an Australian Pension while overseas, select your agreement country below to get the form you need for your claim:
- Austria (German)
- Belgium (Dutch)
- Belgium (French)
- Canada (French)
- Chile (French)
- Cyprus (Greek)
- Cyprus (Turkish)
- Czech Republic
- Korea, Republic of
- North Macedonia
- Slovak Republic
- Switzerland (French)
- Switzerland (German)
- United States - letter
- United States - A4
This form accompanies the Claim for Australian Pension from an agreement country form.
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: 20 March 2020