Instructions

Real estate details

Online services Providing this information online is faster and easier.

You can update your real estate information using your Centrelink online account through myGov.
For help, go to servicesaustralia.gov.au/onlineguides
www.

If you do not have a myGov account, you can create one at my.gov.au and link it to your
www.

Centrelink online account. For more information, go to servicesaustralia.gov.au/register

www.

When to use this form Home property

Use this form if:
• your home property is:
–– more than 2 hectares (5 acres)
–– on more than 1 title, or
–– used for business purposes.
• you are in a care situation and have been absent from your home property for 2 years or more.
• you entered a care situation on or after 1 January 2017 and you are renting out your former
home.
• you have been temporarily absent from your home property for more than 12 months.
Other property
Use this form if you own any real estate not listed above, in Australia and/or outside Australia.

Do not complete this form if:

• the property is fully owned by a private trust and/or private company, and
• you are involved with the private trust and/or private company.
You must complete a Private Company (Mod PC) form and/or Private Trust (Mod PT) form for
each property if you have not done so already.

For more information Go to servicesaustralia.gov.au/realestateincome or servicesaustralia.gov.au/realestateassets

www. www.

If you need to call us, go to servicesaustralia.gov.au/phoneus

www.

We can translate documents you need for your claim or payments for free.
To speak to us in your language, call 131 202.
Call charges may apply.
If you have a hearing or speech impairment, you can contact the TTY service Freecall™
1800 810 586. A TTY phone is required to use this service.

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Authority to inspect Purpose of this authority
the property To enable us to correctly assess your entitlement, it may be necessary for a valuation of the
property to be completed.
To continue paying you your correct entitlement, we may arrange to have the property professionally
valued from time to time, at no cost to you.

Information about having a valuation

Why is a valuation required?
Social security law requires that the value of assets (for example, property, shares in a company,
units in a trust) is included when calculating the amount of pension, benefit or allowance we
pay you.
How is the value of a property decided?
The value of real estate is the current market value, less any allowable debts on the property.
The current market value is the price the owner could expect to receive if the property was sold.
We will maintain the value of the property through regular updates using relevant market data.
What happens if there is no permission to inspect the property?
If the value of the property is likely to affect a person’s entitlement to social security payments or
the rate of payment, but no permission to inspect the property is provided, the person’s payment
may not be granted, payment may be reduced or payment may be stopped.
What if you are not satisfied with the valuation?
If you are unhappy with a valuation, you should contact us. We will check the details, explain
the decision, and if necessary arrange a further valuation. This gives you a chance to correct
misunderstandings or present new information.

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 Filling in this form About your property
You can complete this form on your computer, print and sign it.
If you have a printed form:
5 How many properties in Australia and/or outside Australia do
you (and/or your partner) own or have an interest in?
• Use black or blue pen.
• Print in BLOCK LETTERS.
• Where you see a box like this Go to 1 skip to the question
number shown. You will need to complete and return a separate
Real estate details (Mod R) form for each property
you own if you have not already done so.
1 Is the property fully owned by a private company and/or private If you do not have this form, go to
trust that you are involved in?
www.

servicesaustralia.gov.au/forms
No Go to next question

Yes Do not complete this form. You must complete 6 Address of the property
a Private Company (Mod PC) form and/or
Private Trust (Mod PT) form for each property
if you have not already done so.
If you do not have these forms, go to
www.

servicesaustralia.gov.au/forms

Postcode
About you Country (if not in Australia)

2 Your Customer Reference Number

7 What type of property is this?

Vacant land
3 Your family name
Bush block
Home office/business
First given name House
Self contained flat (part of or
attached to a residence)
Second given name Units/flats/town house
Retail premises
Commercial premises
Industrial premises
4 Your date of birth
Farm (or hobby farm)
/ / Market garden
Residential block larger than
2 hectares (5 acres)
Other Give details below

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8 What is the legal description of the property (for example, lot, 13 What is the value of the rooms or buildings of your home
section, parish – this may appear on the rates notice)? property used only for business?
If the property is made up of more than 1 title, provide details For example, the percentage of the total value of the home
for each separate title. being used for business purposes.

Provide a copy of the latest council rate/valuation 14 Is any portion of the land surrounding your home property used
notice. primarily for business purposes (for example, land surrounding
your home property used as an orchard, even if accessed for
other reasons)?
9 What is the estimate of the current market value of the No Go to 16
property, including land, buildings and water assets
Yes Go to next question
(for example, water rights, allocations or licences)?
You do not need to have the property professionally valued.
We may have the property valued at no cost to you. 15 What is the value of the portion of the land (up to 2 hectares or
5 acres) surrounding your home property that is used primarily
for business purposes?
$
$
Provide a copy of the water rights, allocation or
licence documents, if applicable.
16 Is the property larger than 2 hectares (5 acres)?
No Go to 18
10 Read this before answering the following question. Yes Go to next question
Only answer this question if this property is not your home
property.
17 What is the estimate of the value of the home and surrounding
The current market value of the household contents is what 2 hectares (5 acres)?
you would get if you sold it. It is not the replacement or
insured value. $
Include:
• all furniture (including soft furnishings such as curtains),
antiques and works of art, and 18 Does the property have more than 1 title document?
• electrical appliances such as televisions and fridges. No Go to 20
Yes Go to next question
What is your estimate of the current market value of
the household contents you (and/or your partner) own in
the property? 19 What is the estimate of the value of the home and
surrounding title?
Current market value Amount owed
$
$ $
Provide the legal description and area of the title on which the
Your share % Partner’s share % home sits.

11 Do you (and/or your partner) live on the property?

No Go to 28
Yes Go to next question

12 Are you (and/or your partner) using any rooms or buildings of Provide a copy of each title deed.
your home property only for business (for example, rooms used
exclusively for a bed and breakfast business)?
No Go to 14
Yes Go to next question

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20 Read this before answering the following question. 23 Does any person in your family use the property to support
From 1 July 2017, the qualifying age for Age Pension themselves?
increased from 65 years to 65 years and 6 months. No Go to next question
The qualifying age rises by 6 months every 2 years, reaching Yes Describe how they use the property to support
67 years by 1 July 2023. themselves
To work out if you (or your partner) are Age Pension age, use
the table below.
Date of birth Qualifying age at
1 July 1952 to 31 December 1953 65 years and 6 months
1 January 1954 to 30 June 1955 66 years
1 July 1955 to 31 December 1956 66 years and 6 months
From 1 January 1957 67 years 24 Is there any potential commercial use of the property
(for example, subdividing, agistment, hobby farming)?
Are you (and/or your partner) over Age Pension age and
No Go to next question
receiving or claiming:
• Age Pension Yes Describe the potential commercial use
• Carer Payment
• Pension Bonus Bereavement Payment, or
• Department of Veterans’ Affairs Age Service Pension?
No Go to 28
Yes Go to next question

25 Are there any reasons that stop you (and/or your partner) from
21 Read this before answering the following question. using the property to produce an income?
This question relates to the person who is Age Pension age No Go to 28
and is receiving or claiming:
Yes Go to next question
• Age Pension
• Carer Payment, or
• Department of Veterans’ Affairs Age Service Pension. 26 Why is your property not being used to produce an income?
For Pension Bonus Bereavement Payment, this person may Tick all that apply
also include your late partner.
Rural residential block
Land is not viable for commercial or
Has the property been your home property for 20 years or more agricultural use
continuously?
Caring responsibilities
No Go to 28
Health reasons
Yes Provide documents to provide evidence of the Zoning restrictions
property having been your home property for
20 years or more continuously. Environmental restrictions
Go to next question Other Give details below

22 How do you (and/or your partner) currently use the property?

Tick all that apply
Do not currently make any use 27 Have 2 or more titles been amalgamated since 9 May 2006?
of the property
No
Primary production
Yes
Rural residential only
Leased 28 Who owns the property?
Other commercial or business use You Percentage owned %
(for example, commercial kennels)
Hobby farm Your partner Percentage owned %
Other Give details below
Other Give details below
Name of person/entity

Percentage owned
%

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29 How did this property come into your (and/or your partner’s) Property financial details
ownership?
Purchased Purchase price 33 Is the property mortgaged or encumbered?
$ No Go to 36
Yes Provide the:
Inherited/Gifted
• mortgage or loan agreement(s) showing
Other Give details below
which assets or properties are held as
security against the loan (if applicable),
and
• latest statement of each loan account.

30 When did this property come into your (and/or your partner’s)
ownership (the date of settlement)? 34 Has another property (including your home property) been used
to secure this mortgage?
/ /
No Go to next question
Yes Give details below
31 What is the area or the dimensions of the property?
Address of the other property used to secure the loan.
Complete ONE of these measurements only.

Area in hectares

or Area in acres

or Area in square metres Postcode

X Estimated market value

or Dimensions
$
If your property is made up of more than 1 title, provide a
separate sheet with details of the area or dimensions for If you (and/or your partner) have more than 1 property used
each title. as security, provide a separate sheet with details.

32 Describe all buildings on the property 35 Give details of the loan

This will assist us to value the property. How much do you (and/or your partner) owe?
What is the approximate floor area How old is the $
in square metres? building?
Interest rate per annum
%
Type of construction Purpose of the loan
Exterior (for example, brick, timber)

Interior (for example, plaster, not lined)

If you (and/or your partner) have more than 1 loan, provide a
separate sheet with details.
Roof (for example, metal, tiles)

36 Do you (and/or your partner) receive any rental income from

the lease of the property?
General condition (for example, fair, good, poor)
No Go to 38
Yes Give details below
Total number of flats/units in complex Gross amount of rent received (before tax and other deductions)
(if applicable)
For residential building, number of $ per week
bedrooms
Provide a copy of your (and/or your partner’s):
Number of other rooms
(excluding laundry, bathroom, toilet) • last Income Tax Return
• rental profit/loss statement, and
If you (and/or your partner) have more than 1 building on this • Depreciation Schedule.
property, provide a separate sheet with details.

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37 How many weeks per year is the property rented? Authority to inspect the property
weeks per year
40 Refer to ‘Authority to inspect the property’ in the Notes for
more information.
38 Do you (and/or your partner) receive any non-rental income
from the property? Do you authorise a licenced valuer to enter and inspect the
property for the purposes of a valuation in relation to the
No Go to next question
Social Security (Administration) Act 1999.
Yes Give details below
I understand that if the property to be inspected is not occupied
Source of income (for example, hobby farming, agistment) by me, it is my responsibility to give the actual occupant
reasonable notice, or such notice as is required by agreement,
of the inspection.
This authorisation does not permit the valuer to enter my home,
Gross amount received (before tax) or any dwelling I may own, during the inspection, unless invited
to do so. A similar condition applies to the home of any tenant
$ per week involved.
Provide a copy of your (and/or your partner’s) last I further understand that Centrelink or its representative will
personal and business Income Tax Return and contact me, or the person noted below, to arrange a mutually
financial statements. convenient time for any inspection of the property.

No Go to 43
39 Are there any circumstances affecting the value of the property? Yes Go to next question
This may include details such as:
• no water on property for grazing livestock
41 Person to be contacted by the valuer
• lack of adequate fencing
• hills
• rocky ground Person’s daytime phone number
• natural bushland
• unusual title.

No Go to next question
42 If the property is hard to locate, give full directions or provide a
Yes Give details below map.

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 Checklist Privacy notice

43 Which of the following forms and/or documents are you 44 You need to read this
(and/or your partner) providing with this form?
Privacy and your personal information
Important Note: If you are making a claim, you must return The privacy and security of your personal information is
this form and all other supporting documents at the same important to us, and is protected by law. We need to collect
time you lodge your claim form. If you do not return all this information so we can process and manage your
documents, your claim may not be accepted. The only applications and payments, and provide services to you.
exception will be if you are waiting for medical evidence or We only share your information with other parties where you
other documents from a third party. have agreed, or where the law allows or requires it. For more
information, go to servicesaustralia.gov.au/privacy
www.

If you are not sure, check the question to see if you should
provide the documents.
Tick all that apply 45 Declaration
I declare that:
Real estate details (Mod R) form for each property
• the information I have provided in this form is complete and
you own
correct.
(if required for question 5)
I understand that:
Copy of the latest council rate/valuation notice • if submitting this document as part of a claim, the claim may
(required for question 8) not be accepted unless supporting documents are lodged at
Documents to show details of each water asset the same time as the claim. The only exception will be if
(if required for question 9) I am waiting for medical evidence or other documents from
a third party.
Copy of each title deed
• Centrelink can make relevant enquiries to make sure I
(required for question 19)
receive the correct entitlement.
Documents to provide evidence of the property • giving false or misleading information is a serious offence.
having been your home property for 20 years or more
continuously Your signature
(if you answered Yes at question 21)
Your mortgage or loan agreement(s) showing which On completion of this form,
assets or properties are held as security against the loan please print and sign by hand
and latest statement of each loan account
(if you answered Yes at question 33)
Date
Copy of the last Income Tax Return, rental profit/loss
statement and Depreciation Schedule for the rental / /
property
(if you answered Yes at question 36) Your partner’s signature
Copy of your last personal and business Income Tax
Return and financial statements On completion of this form,
(if you answered Yes at question 38) please print and sign by hand

Date
/ /

Returning this form

Return this form and any supporting documents:
• online using your Centrelink online account. For more
information, go to
servicesaustralia.gov.au/submitdocumentsonline
• in person at one of our service centres, if you are unable to use
your Centrelink online account.

Print Clear
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