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Download english essays and nomilsations and essays and more Summaries English Language in PDF only on Docsity! Residency documents | Medicare contact person Documents from another country me ee * — sale of property (sale agreement) » | You will be the nominated contact person who we will send the — * cessation of lease agreement for rental property ‘| Medicare card(s) and general Information to on behalf of everyone | * — termination of employment (acceptance of resignation by i listed on the Medicare card(s). _ | employer) e — transit document for household goods and/or furniture Your details © closure of bank accounts e ays ice [CF ° cancellation of health, property or contents insurance. 4 Mr Mrs Miss Ms Other | Family name Documents from Australia I * purchase of property agreement and gas or electricity accounts ' x >{ UAM ORO ECee __| _ same name P a ty and rectly | First given name « lease agreement for rental of property and gas or electric ‘ accounts in same name | Qed ev\ * evidence of employment Second given name _ * — evidence of children at school or university ® private health insurance In Australia * — opening of bank accounts 5 Have you ever used or been known by another name? * — property or contents insurance. No [eX Yes [) Give details of your previous name 6 Date of birth 0.3 117 ) 7 Gender Male Female [L) & Postal address SO wey Wn. Wert wore MEL Postcode DL x | 9 Contact phone number NYU Ag yOol__| 10 Ifyou: © are enrolling in Medicare for the first time Goto 17 © ate re-enrolling in Medicare or wanting to extend your Medicare eligibility Your previous Medicare card number (if known) p qu Hb 212 U?}[g Ref no. 2 > Goto 11 « — only want to enrol a dependant in Medicare (for example, a newbom child born overseas or a child aged 12 months or aver). Your current Medicare card number = PE Ref no._i > Goto 19 | |__ ¥so04 2102 30f 13