Applicant instructions

If you were in a FIFO (fly-in, fly-out) work arrangement on 17 October 2024, you can ask your employer to complete this template to show your eligibility for the $200 Individual Power Outage Support Grant – Far West Region October 2024.

Giving false or misleading information is a serious offence. If information is found to be untrue or misleading, the matter may be referred to NSW Police and criminal penalties may apply.

Employer instructions

  1. Copy the text below onto your business letterhead. Your letterhead should include the name, address and ABN/ACN of your business.
  2. Complete all requested information.
  3. Sign the letter (digital signature block accepted) ensuring that it includes:
    • your name and position title
    • telephone number and email address.

If we do not receive all the information requested, it may cause delays in processing applications, and we may have to ask you to supply a new letter.

The information you provide will be assessed in accordance with the guidelines and is subject to the terms and conditions and privacy collection notice.

Letter text

[Company letterhead]

Attention: Service NSW assessment team

Re: $200 Individual Power Outage Support Grant – Far West Region, October 2024

I confirm that I am authorised to complete this letter on behalf of [insert business name] and provide this information with respect to:

Employee's name: [Full name]

Employee's residential and working addresses in the impacted area as at 17 October 2024:
[Residential address]
[Working address]

I confirm that this employee was in a fly-in, fly-out (FIFO) work arrangement on 17 October 2024 and impacted by the event.

[Signature of authorised person]
[Date]
[Name, position title]
[Contact telephone number, email address] 

Last updated: 8 November 2024

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