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.

Download and complete the Authority to release personal information - Personal injury, insurance, superannuation or other matter form.

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.

To fill in this form digitally you will need a computer and Adobe Acrobat Reader, or a similar program. You can download Adobe Acrobat Reader for free. If you can’t complete the form digitally, you can print it, complete it by hand and return it to us following the instructions on the form.

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: 10 December 2021