Completing the Statement form (SS075) 106-07110010

This document outlines the process which will assist in the completion of the Statement form (SS075). The SS075 aims to assist staff to gather the required information in a standard format.

When the Statement form is used

The form is used for Services Australia payments, and should be used by current or prospective customers only.

While the form is usually completed by a Service Officer, customers also have the option of writing the statement themselves. If the form is completed by a Service Officer the customer must read the statement (or have it read to them) and agree on the content. Customers must sign the form acknowledging that the information is complete, correct and in order for it to be valid.

Once completed the form is kept on the customer's record.

The Resources page contains a link to the online version of the SS075.