Application form

The service review process can be lengthy and errors or gaps in information cause additional delay in processing. Therefore, before submitting your application, please ensure:

• you have read all the information provided about the process

• all fields are correctly completed in the form

• you provide sufficient evidence to substantiate the application.

A checklist is provided in the resources below to help you with this.

IMPORTANT: Coal LSL is not authorised to collect employee Tax File Number (TFN) information under privacy legislation, specifically section 8 of the Privacy (Tax File Number) Rule 2015 (TFN Rule), except where expressly authorised.

Under Section 48 of the Coal Mining Industry (Long Service Leave) Administration Act 1992, Coal LSL may be required to collect a TFN for the purpose of making a direct payment to an eligible employee.

To protect your privacy, and ensure our compliance with the legislation, please aim to remove any TFN information in your documents before sending to us. If you supply a document displaying TFN information, we can remove that information before processing your application or ensure adequate security of that information in our systems to protect your privacy.

Download resources

IMPORTANT: When completing a form electronically, ensure full functionality of fillable fields by downloading the form to your computer before completing it.