Payment Assistance Application Form

For customers experiencing financial hardship

Pennytel understands that sometimes customers may have difficulty paying their bill. This may be because of short-term circumstances, longer-term financial difficulty, illness, unemployment, family or domestic violence, a death in the family, natural disaster, reduced income, unexpected expenses, or another reason.


You can use this form to ask Pennytel for payment assistance.
Payment assistance is free. There is no fee to apply. You can apply if you are:
 – a residential customer;
 – small business customer;
 – a not-for-profit customer; or
 – an authorised representative, advocate, financial counsellor or support worker helping one of our customers.
You do not need to be overdue to ask for help. You can apply if you are having difficulty paying now, or if you think you may have difficulty paying soon.

Before you apply

We can provide short-term or longer-term payment assistance.

 – Short-term assistance is help for up to 3 billing cycles.
 – Longer-term assistance is help for more than 3 billing cycles.

Depending on your circumstances, payment assistance may include one or more of the following:
 – extra time to pay;
 – a payment plan based on what you can afford;
 – temporarily postponing or deferring payments;
 – moving you to a lower-cost plan;
 – applying spend controls or usage restrictions;
 – restricting non-essential services to help reduce charges;
 – removing non-essential features or add-ons;
 – changing your billing or payment arrangements;
 – reviewing fees, charges or disconnection/reconnection charges;
 – applying a credit or waiver where appropriate;
 – helping you stay connected while we assess your situation.
You do not need to provide evidence if you are asking for short-term assistance.
You also do not need to provide evidence if your situation involves family or domestic violence.

While we are discussing payment assistance options with you, or assessing your application, we will not take credit management action on your account unless the rules allow us to do so. If we agree a payment assistance arrangement with you, we will not take credit management action while that arrangement is in place, provided you meet the agreed arrangement or stay in contact with us if your circumstances change.

We will assess your application as soon as practicable and within 5 business days after we receive a complete application. We will tell you the outcome as soon as possible and within 2 business days after completing our assessment.We will assess your application as soon as practicable and within 5 business days after we receive a complete application. We will tell you the outcome as soon as possible and within 2 business days after completing our assessment.

If you need urgent help to stay connected, please tell us in the form below.

Need help from someone independent?

You can contact a free financial counsellor through the National Debt Helpline:

 – Phone: 1800 007 007
 – Website: ndh.org.au

If your situation involves family or domestic violence and you need support, you can contact 1800RESPECT:
 – Phone: 1800 737 732
 – Website: 1800respect.org.au

If you are in immediate danger, call 000.

Application Form

Fields marked with * are required

Financial Hardship Assistance Application

1. Who is completing this form?

I am completing this form:
If completing for yourself please proceed to section 2. Customer details

If you are completing this form on behalf of someone else

Your relationship to the customer
Do you have authority to act on the customers behalf?
If you do not already have authority, we may need to confirm this before discussing account details with you. We can still receive the request and take steps to protect the customer’s service while we assess what is needed.

2. Customer Details

Please provide the details of the customer applying for financial hardship assistance
Customer full name
Customer full name
First
Last
Customer type

3. Safe contact preferences

We want to contact you in a way that is safe and suitable for your circumstances.
What is the safest way to contact you?
Please select all that apply
Are there any contact methods we should not use?
Best time to to contact you?
Please select all that apply
Is your request urgent because you may lose access to an important service?

4. Your payment assistance application

You only need to tell us what you are comfortable sharing. You do not need to provide sensitive personal information unless you choose to
Why are you asking for payment assistance?
Select any that apply
This is optional. Please only include information you are comfortable sharing.

5. How long do you think you need help for?

If you need help for up to 3 billing cycles, this is treated as short-term assistance. You do not need to provide evidence for short-term assistance. If you need help for more than 3 billing cycles, we may ask for supporting information if it is reasonably necessary to assess your request. We will not ask for evidence if your situation involves family or domestic violence
I think I need payment assistance for:

6. What help would you like from Pennytel?

Please select the options that may help you
Do you currently have payment assistance or a payment arrangement with Pennytel?

7. What can you afford to pay?

We ask this so we can consider an arrangement that is realistic for you
Can you make a payment now?
Can you make ongoing payments?
How often can you pay this amount?
Would you like payments aligned to when you receive income, wages, pension, benefits or other support payments?

8. Your service needs

We will take into consideration your circumstances and the importance of keeping you connected.
Do you rely on your Pennytel service for any of the following?

9. Supporting information

You do not need to upload documents to apply. You do not need to provide evidence if you are asking for short-term assistance for up to 3 billing cycles or your situation involves family or domestic violence. For longer-term assistance, we may ask for supporting information if it is reasonably necessary to assess your request. We will only ask for information that is relevant to your application.
Would you like to upload any supporting documents now?
Please only upload documents you are comfortable sharing. You may remove or black out information that is not relevant.

Maximum file size: 5MB

Would you prefer to provide supporting information another way?
If yes, how would you like to provide it?

10. Anything else we should know?

Your financial hardship situation might arise from domestic or family violence, an illness or other sensitive circumstances. Perhaps that means you can’t easily take phone calls, but you can call us back if we text you. Or perhaps it’s best that we email you. If there’s anything that you want us to know in order to deal with your application safely and sensitively, please let us know below.

11. Privacy and consent

Pennytel will use the information you provide to: assess your request for payment assistance; contact you about your application; manage any agreed payment assistance arrangement; help keep you connected where appropriate; meet our legal and regulatory obligations; and respond to complaints, disputes or enquiries about your application. Some information you provide may be sensitive, such as information about health, family or domestic violence, financial circumstances or personal hardship. You do not need to provide sensitive information unless you choose to or unless we explain why it is reasonably needed for your application. We will handle your information in accordance with our Privacy Policy and applicable law. We will take reasonable steps to protect your information from misuse, interference, loss, unauthorised access, modification or disclosure.
Acknowledgement
Authority to contact
Privacy acknowledgement