Household Essentials Purchasing Card Application Form

HOUSEHOLD ESSENTIALS PURCHASING CARD

HOUSEHOLD ESSENTIALS

The Household Essentials program provides up to $5,000 per financial year to spend on a range of essential household and personal living expenses.

1Applicant details

2Card Holder Requirements

3Declaration

Applicant details

Language Group(Required)

Yinhawangka

Banyjima

Nyiyaparli

IBN Member’s full name(Required)

Date of Birth(Required)

Your gender(Required)

Male

Female

Registered home address(Required)

Postcode

Phone(Required)

Email Address

For security purposes, you must keep your mobile phone number updated for IBN to order your card and to confirm One Time Payment (OTP) alerts for large amount purchases.

Have your personal details changed?

My address or other personal details have changed.

Yes – My address or other personal details have changed.

Please complete an ‘Update personal details’ form and attach it to your application.

Household Essentials Card – Advisement for Applicants

ATM withdrawals for cash are not accessible.
The Household Essentials Purchasing Card must not be used for Alcohol and Tobacco products.
The Household Essential Purchasing Card must not be used for gambling or online gambling products.
The use of the Household Essentials Purchasing Card must align with the IBN Code of Conduct.

Terms & Conditions

Serious transgressions of the responsibilities listed below, or any breaches of the IBN Code of Conduct may result in the suspension of the Household Essentials Purchasing Card.

The Household Essentials Purchasing Card is to be stored in a secure manner and protected against improper use.
The Household Essentials Purchasing card must not be used to buy unapproved items as listed in the Community Programs Handbook such as alcohol, tobacco, gambling, and online gambling products.
Lost cards shall be reported to an IBN Office and a new Application Form completed to process a replacement card.
The Household Essentials Purchasing Cards can be returned to any IBN Office should the Card Holder decide not to use the card any longer.
Failure to follow any of these requirements could result in the suspension of the card facility.
The Rolling Over of funds does not apply in accordance with the Community Programs Handbook guidelines.
To check your balances, access the ‘website portal here’website portal here

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Total

Declaration (Required)

Declaration(Required)

I declare that the information I have provided in this form is true and correct. I acknowledge that my card and all purchases on it are my responsibility. I agree that IBN may share my information with other organisations for application assessment purposes.

Phone

This field is for validation purposes and should be left unchanged.