Separation details form (MOD S)
Use this form to let us know you’ve separated from your partner.
You may be able to tell us online that you’ve separated instead of filling in this form. Read about updating relationship changes and who can do it online.
If you can’t do it online, download and complete the Separation details form.
Remember to sign it before you submit it with your supporting documents.
The easiest way to do this is to upload them online using:
Read about how to submit your documents online.
This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.
If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please use self service, request someone to deal with us on your behalf, or contact us. We can help you access, complete and submit them.
Page last updated: 23 March 2021
This information was printed 8 May 2021 from https://www.servicesaustralia.gov.au/individuals/forms/mod-s. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.