Conveyance Allowance Application form
Contents
1. EJ Additional information if any ff Parent guardian s bank account details Account details MUST be in the same name as parent guardian or joint account including parent guardian s name Please notify the Department of Transport and Main Roads as soon as possible if these details change Bank state branch number BSB Account number savings or cheque account only Account name s Full name of bank Branch Bank address Postcode El Does the student reside within the south east Queensland school transport zone Refer map over page Yes gt Please go to question 12 over page No gt Please answer the following Does the student reside in one of the following areas The seven week summer vacation zone that is the area in Queensland west of the 144th meridian of east longitude or north of the 16th parallel of south latitude and the following centres Alpha Aramac Augathella Barcaldine Blackall Cameron Downs Charleville Cunnamulla Eulo Hughenden Ilfracombe Isisford Jericho Longreach Muttaburra Prairie Quilpie Tambo Wyandra and Yaraka OR A residence that is more than 50 kilometres measured by the shortest trafficable route from the main Post Office in each of the designated centres Refer to list over page Yes _ No Does the student live more than 16 kilometres from the nearest approved bus service which can transp2. Please read and remove this tear off page not to be returned with this application Conveyance Allowance Application Queensland School Transport Assistance Scheme STAS Government The instructions must be read before completing this form Please remove this page and keep it for your records Applying for conveyance allowance Complete this form if you wish to apply for conveyance allowance assistance Fill in all questions on the form If you do not it may delay processing of your form Only the parent guardian shown on this form at Question 1 may alter or amend travel or personal details for students listed in this application You can log onto www information qid gov au and click on the image Queensland Atlas to access your lot and registered plan number Once in the atlas under the search tab on the left hand side of the screen at point 2 enter your address and click find The lot and plan number will display at point 3 Alternatively look at your rates notice or contact your local council to get your lot and plan number Send the completed form to your nearest Department of Transport and Main Roads office Office locations are listed over the page Applications can only be accepted for the current school year and must be received by 31 December The department confirms student attendance with schools before payment can be made If you submit your form after school has finished for the year you will not be paid until after
3. Please read and remove this tear off page not to be returned with this application ClassD Payable for students living outside the Brisbane City Council local government boundary and attending non state schools if the students are conveyed by private motor vehicle to school e conveyed by private motor vehicle more than 3 2 kilometres to the nearest point from which another form of transport is available which can transport the student to school For primary school students years prep 6 the distance to the nearest school of the type attended must be more than 3 2 kilometres For secondary school students years 7 12 this distance must exceed 4 8 kilometres The class D allowance is not available for a student for whom class A or class C is payable or for a student who lives within 1 6 kilometres of the route of a kilometre based school bus service on which a student is eligible to travel at no cost to a school of the type attended This allowance is paid on a per vehicle basis Please note Conveyance allowance class A C or D is paid on a per vehicle basis and is generally only payable for one vehicle However in extreme circumstances consideration may be given for the use of two vehicles or one vehicle doing two trips In these cases full documentation including vehicle details and registration numbers may be required A Statutory Declaration to the effect that two vehicles are being utilised on a full time basis may also
4. a new application within seven days should there be any change in the information contained in this application It is further understood that the department reserves the right to withdraw travel assistance and recover monies paid if investigations show the student s to be ineligible understand that persons who intentionally provide false information to obtain a benefit may be liable to a 6600 fine under Section 149 3 of the Transport Operations Passenger Transport Act 1994 In order to assess an applicant s ongoing entitlement to assistance the department will verify student s personal details with the school attended and schools will disclose to the department updated information for that purpose By signing the certification below am authorising this exchange of personal information between the department and schools Signed Date Privacy statement The department collects the information on this form as authorised under the Transport Operations Passenger Transport Act to assess eligibility for conveyance allowance These details are accessible by authorised departmental staff These details may also be provided to bus operators and the Department of Education Training and Employment staff as required Your and the student s personal information will not be disclosed by the department to any other third party without your consent unless required to do so by law or for the purpose of Information Privacy Act 2009 Some
5. be required If claiming class B conveyance allowance documentary evidence may be requested Retrospective applications for travel in previous years will not be approved Additional assistance may be available to families who reside on drought declared primary producing properties and who are eligible to receive conveyance allowance class A or C To receive drought assistance a drought assistance application must also be completed Assistance for isolated students Conveyance allowance class assists students in isolated areas In addition to the general conditions of eligibility for conveyance allowance to be eligible for class students must 1 Reside more than 16 kilometres from the nearest state school and the nearest approved bus service which can transport the student to school 2 Reside outside the south east Queensland school transport zone refer to map 3 a Reside in the seven week summer vacation zone that is the area in Queensland west of the 144th meridian of east longitude or north of the 16th parallel of south latitude and the following centres Alpha Aramac Augathella Barcaldine Blackall Cameron Downs Charleville Cunnamulla Eulo Hughenden Ilfracombe Isisford Jericho Longreach Muttaburra Prairie Quilpie Tambo Wyandra and Yaraka OR 3 b Reside more than 50 kilometres measured by the shortest trafficable route from the main post office in the centres designated by the Director General Dep
6. of the student s personal information including name school and current year level may appear on a bus pass created and issued at the request and discretion of the relevant bus operator Section B Map of south east Queensland school transport zone South East Guoonaland Sehoeal Trt port Zana Designated centres Hal Atherton Malanda i ir Atherton Post Shop Malanda LPO pi a Fo Ayr Mareeba a is ri Ayr Post Shop Mareeba Post Shop _ tl Bowen Maryborough H Bowen Post Shop Maryborough r a 4 2 I T Bundaberg Post Shop k iig i 5 1 Bundaberg Post Shop Mossman J 7 it Cairns Mossman Post Shop 2 oo mmmn Toe Cairns Central Proserpine 1 Mi l P Post Shop Proserpine Post Shop f J ra Dalby Ravenshoe eas T re Dalby Post Shop Ravenshoe LPO i i ia Gladstone Rockhampton Fi E Gladstone Post Shop Rockhampton Post i a 4 Fe i Gympie Shop i ati fO ea Gympie Post Shop Sarina De og E Hervey Bay Sarina Post Shop E pa i p ee s k Hervey Bay Stanthorpe a nt aos a Sy Post Shop Stanthorpe Post Shop meme OP ee FY a Home Hill Toowoomba 4 i 3 Ti Jal Home Hill LPO Toowoomba BC i j inf L Ingham Townsville i p 1 ee Ingham Post Shop Townsville Post Shop 7 mem wm a meas Jas ia Innisfail Tully om i Innisfail Post Shop Tully Post Shop 7 Kingaroy Warwick Kingaroy Post Shop Warwick Post Shop Kee South fees Mackay SEQ Scho Tappo fone Mackay Post Shop TRB Forms Area Form F3647 CFD V01 Aug 2014
7. school resumes the following year Parents guardians must advise the department of any changes to bank account details If you don t your payment may be delayed A new application is required to be completed within seven days when a child changes school and or address You will be advised in writing of approval details before the first payment is made in June If the student has been travelling on the local bus service as a School Transport Assistance Scheme STAS eligible student and then stops using this service you must tell the department within seven days Eligibility Eligibility for STAS is dependent on the applicant meeting all relevant criteria of the scheme The distance criteria as well as other general conditions must be met before assistance can be approved Full details can be found at www translink com au schooltransport The following conditions relate to conveyance allowance f Students must be enrolled at an approved school 2 Primary school students years prep 6 must live more than 3 2 kilometres by the shortest trafficable route from the nearest state primary school In addition non state students must also live more than 3 2 kilometres from the nearest non state school of the type attended 3 Secondary school students years 7 12 must live more than 4 8 kilometres by the shortest trafficable route from the nearest state secondary school In addition non state students must also live more than 4 8 kilometres from
8. Qld 4350 Mackay Qld 4740 Cairns Qld 4870 Phone 5585 1857 Phone 4639 0727 Phone 4951 8673 Phone 4045 7085 Ipswich Roma South West Rockhampton Townsville PO Box 631 PO Box 126 PO Box 5096 PO Box 7466 Ipswich Qld 4305 Roma Qld 4455 Red Hill Garbutt BC 4814 Phone 3813 8613 TransLink SEQ North Carseldine PO Box 156 Zillmere Qld 4034 Phone 3863 9849 Mooloolaba PO Box 111 Mooloolaba Qld 4557 Phone 5452 1800 Phone 4622 9509 Maryborough Wide Bay Burnett PO Box 371 Maryborough Qld 4650 Phone 4122 6115 Rockhampton Qld 4701 Phone 4931 1539 Phone 4758 7544 TRB Forms Area Form F3647 CFD V01 Aug 2014 Queensland RI Government DTMR Code The information on the tear off page must be Vv read before completing this form Section A to be completed by parent guardian Conveyance Allowance Application School Transport Assistance Scheme STAS TMR use only STIMS The following information will be used to determine eligibility in accordance with the policy of the STAS El Parent guardian details Only the parent guardian shown here will be able to alter or amend travel details for students listed in this application Title Family name Given name s Your principal place of residence include property name and rural number if applicable Postcode Please also provide your registered plan and lot number This information is needed to assess eligibility Lot numbe
9. artment of Transport and Main Roads refer to list of designated centres 4 Class conveyance allowance is not payable for the same journey for a student in receipt of class A C or D conveyance allowance or drought assistance additional conveyance allowance Change of circumstances A new application form must be submitted within seven days if a student changes school or address If any other information on this form changes you must advise the department within seven days If a student is modifying bus travel arrangements the bus company must be notified of the change If applicable the bus pass must be returned to the bus company A Statutory Declaration may be required to confirm the date used for amending bus assistance and commencing conveyance allowance The department reserves the right to withdraw travel assistance and recover monies paid if investigations show the student to be ineligible Persons who intentionally provide false information to obtain a benefit may be liable to a 6600 fine under Section 149 3 of the Transport Operations Passenger Transport Act 1994 Departmental offices Further information on the STAS can be obtained from the following offices or online at www translink com au schooltransport TransLink SEQ South TransLink Southern TransLink Central TransLink Northern Southport Toowoomba Darling Downs Mackay Cairns PO Box 10420 PO Box 629 PO Box 62 PO Box 6542 Southport BC Qld 4215 Toowoomba
10. ction s below State primary gt Please complete section A below Non state primary gt Please complete section A and B below State secondary gt Please complete section C below include any state senior colleges Non state secondary gt Please complete section C and D below TMR use only Distance Verification Date Initials Section Type of school Name of nearest school to your house one way Map info On road A Nearest state primary km km km I l B Nearest non state primary km km km C Nearest state secondary km km km D Nearest non state secondary km km km of the type attended TRB Forms Area Form F3647 CFD V01 Aug 2014 El Names of student s applying for conveyance allowance IMPORTANT Student details must match records held by the school attended Family name Given name el tad fade args overseas eae peel M F YIN school 1 boal km 2 bod km 3 h ki 4 of km Refer to point 4 under Eligibility on tear off page for details on measuring Refer to point 7 under Eligibility on tear off page EJ Mode of transport used by the student s Method s of travel please tick v Complete this section if a refund or part refund of fares seeking Refer to Change of circumstances section on the tear off page On what days will t
11. he student be conveyed Please tick v the days and whether am pm specific times are not necessary Date from Private Private Private Fares ae which vehicle vehicle vehicle based Name of fares based Weekly Gs shown above allowance home to to bus to rail bus bus company fares paid is sought school service service service Al 2 3 4 Total weekly fare Student s Monda Tuesday Wednesday Thursda Frida given name y 4 y y y afternoon by as shown above am pm am pm am pm am pm am pm Yes Are student s conveyed each day morning and No m Please give details below the same means of transport Do the students travel by private motor vehicle to either a bus or rail service No L Yes gt please complete the following details Student s given name ek Be aa Se Ww o ae oer 1 km km km 2 km km km 3 km km km 4 km km km Refer to Class C under Types of Conveyance Allowance on tear off page for more details Names of other students already receiving or applying for transport assistance Do not include students listed at question 4 Family name Given name Date of birth Type of assistance you get for this student or type applied for TRB Forms Area Form F3647 CFD V01 Aug 2014
12. ort the student to school No E Yes gt How far from the bus service does the student live km What is the name of the bus operator company who operates this service continued over page at question 12 Certification over page must be completed If you do not it will delay approval of assistance Student s name Code Class Scale Initials Travel Approval notes es No 1 2 3 4 Approving officer s certification Input officer s certification have assessed this application in accordance with the have reviewed travel details on this application with details approved school transport policies and procedures and recorded in STIMS and confirm the student s is are not receiving certify that the student s is are entitled to the level of assistance for the same journey s approved on this application assistance granted Appropriate details have been accurately recorded in accordance Officer s signature with the STIMS user manual Officer s signature Date I Date entered TRB Forms Area Form F3647 CFD V01 Aug 2014 Certification by parent guardian certify that the above information provided is true and correct and have read and agree to the conditions of travel as listed on the attachment of this application understand that am required to complete
13. over the page Types of conveyance allowance The following is a summary of the different types of conveyance allowance that are payable for eligible students It is a summary only and parents do not need to determine what type of assistance they are eligible for This will be done by the department Class A Payable to parents or guardians of students who are conveyed by private motor vehicle to primary secondary school provided that the students do not reside within 3 2 kilometres of a kilometre based school bus service This allowance is paid on a per vehicle basis Class B Payable to parents or guardians of eligible students who reside in the area of the Brisbane City Council and use a Brisbane Transport fares based bus service to travel to school or to a railway station in order to attend school Parents are entitled to a refund of the assessed fare Documentation verifying such expenditure may be requested Class C Payable to parents or guardians of students who must be conveyed by private motor vehicle to a railway station or a school bus service kilometre based or fares based in order to attend school provided the distance travelled is more than 3 2 kilometres to the designated service for the area in which they reside The distance conveyed is measured from the student s residence to the nearest point on the bus route not to the bus stop This allowance is paid on a per vehicle basis TRB Forms Area Form F3647 CFD V01 Aug 2014
14. r Registered plan Survey plan number Note If you do not provide all information it may delay approval for transport assistance Your registered plan and lot number can be found on your rates notice Alternatively you can phone your local council and ask for this information or log onto www information qld gov au More information about this website Postal address Please tick if the same as above is under Applying for conveyance allowance Home telephone number Work telephone number Mobile telephone number Email address IMPORTANT For fast processing these details should be the same as those held by the student s school F Reason for making this application New application Change of school gt Name of previous school attended Last date of enrolment Change of address gt Previous residential address Last date at that address Change of mode and or frequency of travel for gt Please provide details Please ensure questions 5 and 6 are completed Date of change example changing from bus to car Other gt Please provide details Date of change It is important to advise the school of any change of address If you don t it may affect your assistance Distance to nearest school by the shortest trafficable route Please tick Y what type of school s the student s attend and complete the appropriate se
15. the nearest non state school of the type attended 4 Measuring The distance from your residential property to the school is measured by the shortest trafficable route over roads open for public use Distances are measured from the vehicle access point of your residential property alignment nearest to the school to the closest entrance to the school No measurements are made on private property In calculating this distance the single journey is used However in cases where the distance to and from school varies because of different routes that is one way roads the average distance is taken 5 For non state school students residing outside the Brisbane City Council local government boundary additional provisions for an allowance are available irrespective of the distance to the nearest state primary and or secondary school refer class D below 6 School transport assistance is only available from one address and to one school facility This address must be the principal place of residence of the student s parent or guardian For students under shared guardianship parents must decide from which address they will apply for assistance T Student from overseas interstate or on student exchange programs are not eligible to receive transport assistance Note More detailed eligibility information regarding the conveyance allowance scheme including rates of payment may be obtained by contacting the nearest departmental regional office listed
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