Financial Hardship Assistance – Application Form

MATE Financial Hardship Assistance Application

(Note: Evidence that we request from you under paragraph 15 of our Payment Assistance Policy counts as part of this application, and your application is not complete until the evidence has been provided to us.)

If you have any questions about this policy or application, contact us by calling 02 8357 0513 during the following days and hours: Monday to Friday – 8:30 AM to 7 PM AEST/AEDT; or email [email protected].

Part 1: Customer Details

Name(Required)

Enter your full name below

Account number(Required)

Enter your MATE account number below. You can find your account number on your invoice (this may also be referred to as your MATE code)

Invoice number(Required)

Enter the tax invoice number your application relates to below

Phone number(Required)

*Enter your preferred phone number below. Please provide the number associated with your MATE account

Email address(Required)

*Enter your preferred email address below. Please provide the email associated with your MATE account

* Unless you request otherwise, we may contact you via any of these contact points.

Do you have existing financial hardship assistance from MATE?(Required)

Do you have existing financial hardship assistance from MATE?

If ‘yes’, provide details

If ‘yes’, provide details below

Part 2: Assistance eligibility

Please complete this part of the application by ticking each box that is next to a statement that is correct. You can leave any untrue statement boxes blank.

Section 1(Required)

Section 1

1. You are an individual person, and you mainly use your MATE service for personal or domestic purposes.
2. You are a not-for-profit organisation.
3. You are a business, and when you entered your MATE contract, you didn’t have a genuine and reasonable opportunity to negotiate the terms, and your expected annual telco spend was $40,000 or less.

Section 2(Required)

Section 2

4. You don’t sell the use of your service to anyone else.

Section 3(Required)

Section 3

5. You owe us or will owe us, money that you can't pay.

Section 4(Required)

Section 4
The reason you can’t pay is because: (select at least one option)

Section 5(Required)

Section 5
You believe that you will be able to pay if we agree: (select at least one option)

(a) to allow you more time to pay a bill
(b) to accept a payment plan tailored to your ability to pay
(c) to put controls on you incurring charges e.g. spend controls
(d) to put restrictions on your service
(e) to remove non-essential service features, without any cost penalty to you
(f) to transfer you to a different product that better suits your circumstances
(g) to adjust internal threshold limits so that you are not disconnected

Section 6(Required)

Section 6

You wish to access one or more of the assistance options you have ticked above.

Part 3: What financial hardship assistance do you request?

What we can do to help you get your telco contract payments up to date;

What you can do to get them up to date;

For how long you feel you need help.

I believe I am able to pay the following amount:(Required)

I believe I am able to pay the following amount:

I believe I can pay this amount every:(Required)

I believe I can pay this amount every:

Week
Fortnight
Month

I believe I can pay this amount from the following date(Required)

I believe I can pay this amount from the following date:

Part 4: Special instructions – sensitive circumstances

Special instructions Summary

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.

(This is optional, but this information may help us to help you more safely and sensitively.)

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Phone

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Financial Hardship Assistance – Application Form | MATE

MATE Financial Hardship Assistance Application

Part 1: Customer Details

Part 2: Assistance eligibility

Part 3: What financial hardship assistance do you request?

Part 4: Special instructions – sensitive circumstances