This information will help you complete the Statement of Earnings form and the Change in Family Circumstances form.

It provides examples of extra information and evidence you may need to provide to the TAC.

This will help us manage your claim and ensure the Loss of Earnings Capacity (LOEC) benefits you are receiving are correct.

If you are unable to provide any of the information requested, please let us know the reason you are unable to provide it.

Statement of Earnings

If you are an employee (current or recently)

If you have any income or earnings from employment including supported employment, please provide the following documents:

• Income Tax Return (most recent financial year)
• Australian Taxation Office (ATO) Assessment Notice (most recent financial year)
• Payslips (if you have started employment in the current financial year)

If you are participating in a supported employment program, you can earn up to a certain amount without impacting your LOEC payments.

For more information please see the Supported Employment Program page.

If you are self-employed

If you have any income, earnings or losses from a business, partnership, company trust or other entities, please provide the following documents from the most recent financial year:

• Income Tax Returns
• Profit and Loss Statements
• Business Activity Statements

Change in family circumstances

If you have family members who are dependent on you for economic support, we need evidence of this to help us determine your LOEC benefits.

A dependent person may include a spouse, partner or children who rely on you for financial support in some way.

Evidence you can provide to help us understand your family circumstances includes (but is not limited to):

For a spouse or partner

• A copy of the marriage certificate (if applicable).
• Evidence of financial dependency (i.e. copies of joint accounts, loans, household bills in either both names or individual names for the same address, insurance policies, lease agreements etc).

For children

• A copy of each child’s full birth certificate (not extracts).
• Evidence of financial dependency (must show each child’s name and date of birth such as school payments, bank accounts, medical bills, child support agency assessment letters etc).
• A letter from a school/university/college/TAFE confirming your child’s enrolment as a full-time student or apprentice (if aged between16-25).

Your privacy

The TAC needs this information to make decisions about your entitlement to TAC benefits. We may use or disclose it to make further inquiries or assist in the ongoing management of the claim or any claim for common law damages.

The TAC may also be required by law to disclose this information. Without this information, the TAC may be unable to determine entitlements or approve further benefits. More information is available at tac.vic.gov.au/yourprivacy