Australian Government Department of Human Services 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Provider Agency Name and Address in the designated fields. Ensure that all information is accurate to avoid any issues.
3. Fill in the Contact Individual and Title, along with the Telephone Number. This information is crucial for communication regarding your submission.
4. Specify the Agency Fiscal Year To be Audited and provide the Federal ID No. and Charities Registration No. as required.
5. List all State and Federal Financial Assistance during the fiscal year under audit, using the provided sections for each entry.
6. Complete details about the Licensed Public Accountant, including Firm Name, Address, Telephone No., and License No. Attach a photocopy of the firm’s license if necessary.
7. Certify your understanding of requirements by signing at the bottom of the form, ensuring that all information provided is accurate.

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