housingselfservice.hpw.qld.gov.au
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131.242.100.121
Public Scan
URL:
https://housingselfservice.hpw.qld.gov.au/
Submission: On June 15 via automatic, source certstream-suspicious — Scanned from DE
Submission: On June 15 via automatic, source certstream-suspicious — Scanned from DE
Form analysis 4 forms found in the DOM
POST https://find.search.qld.gov.au/s/search.html
<form action="https://find.search.qld.gov.au/s/search.html" id="search-form" method="post" role="search">
<div>
<label for="search-query" class="visuallyhidden">Search website</label>
<input accesskey="5" type="search" name="query" id="search-query" size="27" value="" placeholder="Search website" role="combobox" autocomplete="off" aria-autocomplete="both" aria-owns="suggestbox">
<ul role="listbox" class="listbox" aria-busy="true" id="suggestbox"></ul>
<input id="search-button" type="image" src="//static.qgov.net.au/assets/v2/images/skin/button-search.png" value="Search">
<input type="hidden" name="num_ranks" value="10">
<input type="hidden" name="tiers" value="off">
<input type="hidden" name="collection" value="qld-gov">
<input type="hidden" name="profile" value="qld">
</div>
</form>POST /
<form action="/" autocomplete="on" enctype="multipart/form-data" method="post" novalidate="novalidate"><input name="__RequestVerificationToken" type="hidden"
value="Hl48kycVGFQmRtdhch9ir-xxG2AzRw0q4lxOJCKZS5UhUEbh7EdT8RrMLjgkvIYvtPBI27doz9XlSVgexwlBww8wuac1" class="ea-triggers-bound">
<div class="validation-summary-valid" data-valmsg-summary="true">
<ul>
<li style="display:none"></li>
</ul>
</div>
<h2>Your personal details</h2>
<p>
<label class=" control-label" for="RentalAgreementNumber">Rental agreement number</label><abbr id="RentalAgreementNumberRequiredFieldInidcator" class="required" aria-required="true">*</abbr>
<br>
<input autofocus="autofocus" data-val="true" data-val-number="The field Rental agreement number must be a number." data-val-required="The Rental agreement number field is required." id="RentalAgreementNumber" name="RentalAgreementNumber"
type="text" value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="RentalAgreementNumber" data-valmsg-replace="true"></span>
</p>
<fieldset>
<input data-val="true" data-val-required="The IsPhoneNumberRequired field is required." id="Tenant_IsPhoneNumberRequired" name="Tenant.IsPhoneNumberRequired" type="hidden" value="True" class="ea-triggers-bound">
<p>
<label class="required-label control-label" for="Tenant_FirstName">First name</label>
<br>
<input class="col-md-2 ea-triggers-bound" data-val="true" data-val-required="The First name field is required." id="Tenant_FirstName" name="Tenant.FirstName" type="text" value="">
<span class="field-validation-valid" data-valmsg-for="Tenant.FirstName" data-valmsg-replace="true"></span>
</p>
<p>
<label class="required-label control-label" for="Tenant_LastName">Last name</label>
<br>
<input data-val="true" data-val-required="The Last name field is required." id="Tenant_LastName" name="Tenant.LastName" type="text" value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="Tenant.LastName" data-valmsg-replace="true"></span>
</p>
<p>
<label class="required-label control-label" for="Tenant_DOB">Date of birth</label> (e.g. 12/06/1971) <br>
<input class="date-picker-birthday text-box single-line ea-triggers-bound" data-val="true" data-val-date="The field Date of birth must be a date." data-val-pastdate="Date of Birth should be in the past"
data-val-required="The Date of birth field is required." id="Tenant_DOB" name="Tenant.DOB" type="date" value="">
<span class="field-validation-valid" data-valmsg-for="Tenant.DOB" data-valmsg-replace="true"></span>
</p>
<p>
<label class="control-label" for="Tenant_ContactType">How can we contact you?</label><br>
<input data-val="true" data-val-number="The field How can we contact you? must be a number." data-val-required="The How can we contact you? field is required." id="ContactType" name="Tenant.ContactType" onchange="ToggleValue(this);"
type="radio" value="1" class="ea-triggers-bound"> Email<br>
<input id="ContactType" name="Tenant.ContactType" onchange="ToggleValue(this);" type="radio" value="2" class="ea-triggers-bound"> Phone<br>
<input id="ContactType" name="Tenant.ContactType" onchange="ToggleValue(this);" type="radio" value="3" class="ea-triggers-bound"> Mail
</p>
<p>
<label class="control-label" for="Tenant_Email">Email address</label><abbr id="email-required" class="required" aria-required="true" style="display: none;">*</abbr>
<br>
<input data-val="true" data-val-requiredif="The Email address is required." data-val-requiredif-allowempty="false" data-val-requiredif-expression=""ContactType == 1""
data-val-requiredif-fieldsmap="{"ContactType":"number"}" id="Email" name="Tenant.Email" type="text" value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="Tenant.Email" data-valmsg-replace="true"></span>
</p>
<p class="required-label">(You must provide at least one contact number)</p>
<p>
<label class=" control-label" for="Tenant_MainContactNumber">Phone number</label>
<br>
<input class="text-box single-line ea-triggers-bound" data-val="true" data-val-regex="Entered phone format is not valid." data-val-regex-pattern="^\d{8}$|^\d{9}$|^\d{10}$"
data-val-requiredif="Phone number is required if mobile number is empty." data-val-requiredif-allowempty="false" data-val-requiredif-expression=""AlternativeContactNumber == null && IsPhoneNumberRequired == true""
data-val-requiredif-fieldsmap="{"AlternativeContactNumber":"string","IsPhoneNumberRequired":"bool"}" id="Tenant_MainContactNumber" name="Tenant.MainContactNumber" type="text" value="">
<span class="field-validation-valid" data-valmsg-for="Tenant.MainContactNumber" data-valmsg-replace="true"></span>
</p>
<p>
<label class=" control-label" for="Tenant_AlternativeContactNumber">Mobile number</label><abbr id="Tenant_AlternativeContactNumberRequiredFieldInidcator" class="requiredSpace"></abbr>
<br>
<input class="text-box single-line ea-triggers-bound" data-val="true" data-val-regex="Entered phone format is not valid." data-val-regex-pattern="^\d{8}$|^\d{9}$|^\d{10}$"
data-val-requiredif="Mobile number is required if phone number is empty." data-val-requiredif-allowempty="false" data-val-requiredif-expression=""MainContactNumber == null && IsPhoneNumberRequired == true""
data-val-requiredif-fieldsmap="{"MainContactNumber":"string","IsPhoneNumberRequired":"bool"}" id="Tenant_AlternativeContactNumber" name="Tenant.AlternativeContactNumber" type="text" value="">
<span class="field-validation-valid" data-valmsg-for="Tenant.AlternativeContactNumber" data-valmsg-replace="true"></span>
</p>
</fieldset>
<h2>Your address</h2>
<p>If you cannot find your suburb by name, please enter your postcode. If there is no match, please contact your nearest <a href="/Go/housing-service-centre-web" target="_blank">Housing Service Centre</a><small class="print-link-url"> (
https://housingselfservice.hpw.qld.gov.au/Go/housing-service-centre-web )</small></p>
<fieldset>
<input data-val="true" data-val-required="The IsUnitStreetNoRequired field is required." id="IsPostalUnitStreetNoRequired" name="PropertyAddress.IsUnitStreetNoRequired" type="hidden" value="True" class="ea-triggers-bound">
<div>
<p>
<label class="required-label control-label" for="PropertyAddress_SuburbPostcode">Suburb or postcode</label>
<br>
<input type="hidden" id="PropertyAddress_SuburbPostcode" name="PropertyAddress.SuburbPostcode" value=""><input type="text" class="cascade-suburb-postcode ea-triggers-bound" id="PropertyAddress_SuburbPostcode_quickselect" accesskey="undefined"
tabindex="undefined" autocomplete="off">
<span class="field-validation-valid" data-valmsg-for="PropertyAddress.SuburbPostcode" data-valmsg-replace="true"></span>
</p>
<div id="divNotPoBox">
<p>
<label class="required-label control-label" for="PropertyAddress_Street" id="PropertyAddress_Street">Street</label>
<br>
<select class="cascade-street ea-triggers-bound" data-street-list="/HouseholdMember/StreetsForSuburb" id="PropertyAddress_Street_ddl" name="PropertyAddress.Street">
<option value="">-- Please select --</option>
</select>
<span class="field-validation-valid" data-valmsg-for="PropertyAddress.Street" data-valmsg-replace="true"></span>
</p>
<p>
<label class="required-label control-label" for="PropertyAddress_UnitStreetNo" id="PropertyAddress_UnitStreetNo">Unit/Street number</label>
<br>
<input data-val="true" data-val-requiredif="The Unit/Street number field is required." data-val-requiredif-allowempty="false" data-val-requiredif-expression=""IsUnitStreetNoRequired == true""
data-val-requiredif-fieldsmap="{"IsUnitStreetNoRequired":"bool"}" id="PropertyAddress_UnitStreetNo_Editor" name="PropertyAddress.UnitStreetNo" type="text" value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="PropertyAddress.UnitStreetNo" data-valmsg-replace="true"></span>
</p>
</div>
<div id="divPoBox" style="display: none;">
<p>
<label class="required-label control-label" for="PropertyAddress_PoBox">PO Box</label>
<br>
<input data-val="true" data-val-required="The Po Box field is required." id="PropertyAddress_PoBox" maxlength="50" name="PropertyAddress.PoBox" type="text" value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="PropertyAddress.PoBox" data-valmsg-replace="true"></span>
</p>
</div>
</div>
</fieldset>
<script language="javascript" src="/Scripts/address.js"></script>
<script type="text/javascript">
$(document).ready(function() {
$("#divPoBox").hide();
$("#email-required").hide();
$("#divPoBoxRadio").css("display", "none"); //$("#divPoBoxRadio").attr("style", "display:none");//$("#divPoBoxRadio").hide();
//debugger;
if ('' != null && '' == 'True') {
ToggleInfo();
$("#PropertyAddress_UnitStreetNo").removeClass("required-label")
$("#PropertyAddress_Street").removeClass("required-label")
ToggleValue();
}
})
function ToggleInfo() {
//debugger;
value = $('[id="IsPoBox"]:checked').val();
if (value != null) {
if (value.toLowerCase() == "true") {
$("#divNotPoBox").hide();
$("#divPoBox").show();
} else {
$("#divNotPoBox").show();
$("#divPoBox").hide();
}
}
};
function ToggleValue() {
//debugger;
contactType = $('[id="ContactType"]:checked').val(); // 1.Email 2.Phone 3.Mail
tenantType = $("#ddl-TenantTypeId").val();
IsPoBox = $('[id="IsPoBox"]:checked').val();
if (contactType == 1) $("#email-required").show();
else $("#email-required").hide();
if (tenantType == 1 || tenantType == 5) {
$("#PropertyAddress_UnitStreetNo").addClass("required-label")
$("#PropertyAddress_Street").addClass("required-label")
} else if (tenantType == 2 || tenantType == 3 || tenantType == 4) {
$("#PropertyAddress_UnitStreetNo").removeClass("required-label")
$("#PropertyAddress_Street").removeClass("required-label")
}
if (contactType == 3 || ((tenantType == 1 || tenantType == 5) && IsPoBox != true)) {
$("input#IsPostalUnitStreetNoRequired").val(true);
$("#PropertyAddress_UnitStreetNo").addClass("required-label")
$("#PropertyAddress_Street").addClass("required-label")
} else if (contactType == 1 || contactType == 2 || contactType == -1) {
if (tenantType == 1 || tenantType == 5) {
$("#PropertyAddress_UnitStreetNo").addClass("required-label")
$("#PropertyAddress_UnitStreetNo").addClass("required-label")
$("#PropertyAddress_Street").addClass("required-label")
} else if (tenantType == 2 || tenantType == 3 || tenantType == 4) {
$("input#IsPostalUnitStreetNoRequired").val(false);
$("#PropertyAddress_UnitStreetNo").removeClass("required-label")
$("#PropertyAddress_Street").removeClass("required-label")
}
}
//debugger;
if (contactType == 3) {
//$("#IsPoBox").attr('checked', false);
$("#IsPoBox").attr('disabled', false);
$("#divPoBoxRadio").css("display", "block"); //$("#divPoBoxRadio").attr("style", "display:block");//$("#divPoBoxRadio").show();
} else {
$("#divPoBoxRadio").css("display", "none"); //$("#divPoBoxRadio").attr("style", "display:none");//$("#divPoBoxRadio").hide();
$("#divNotPoBox").show();
$("#divPoBox").hide();
$("input[name='PropertyAddress.IsPoBox'][value='False']").prop('checked', true);
}
};
</script>
<h2>Your postal address</h2>
<fieldset>
<div>
<input data-val="true" data-val-required="The IsUnitStreetNoRequired field is required." id="IsUnitStreetNoRequired" name="PostalAddress.IsUnitStreetNoRequired" type="hidden" value="true" class="ea-triggers-bound">
<div id="divPostalPoBoxRadio">
<p>
</p>
<div class="col-md-12" style="width:50%">
<div style="float:left;">
<input data-val="true" data-val-required="The IsPoBox field is required." id="IsPostalPoBox" name="PostalAddress.IsPoBox" onchange="ToggleAddress(this);" type="radio" value="True" class="ea-triggers-bound"> PO Box
</div>
<div style="float:right;">
<input id="IsPostalPoBox" name="PostalAddress.IsPoBox" onchange="ToggleAddress(this);" type="radio" value="False" class="ea-triggers-bound"> Street address
</div>
</div>
<p></p><br>
</div>
<p id="divSameAddress">
<input id="PostalAddress_chkSameAddress" name="PostalAddress.chkSameAddress" type="checkbox" value="true" class="ea-triggers-bound" disabled=""><input name="PostalAddress.chkSameAddress" type="hidden" value="false" class="ea-triggers-bound">
Same as above
</p>
<p>
<label class=" control-label" for="PostalAddress_SuburbPostcode">Suburb or postcode</label><abbr id="PostalAddress_SuburbPostcodeRequiredFieldInidcator" class="required" aria-required="true">*</abbr>
<br>
<input type="hidden" id="PostalAddress_SuburbPostcode" name="PostalAddress.SuburbPostcode" value=""><input type="text" class="cascade-suburb-postcode ea-triggers-bound" id="PostalAddress_SuburbPostcode_quickselect" accesskey="undefined"
tabindex="undefined" autocomplete="off">
<span class="field-validation-valid" data-valmsg-for="PostalAddress.SuburbPostcode" data-valmsg-replace="true"></span>
</p>
<div id="divPostalStreetAddress">
<p>
<label class="required-label control-label" for="PostalAddress_Street">Street</label><abbr id="PostalAddress_StreetRequiredFieldInidcator" class="requiredSpace"></abbr>
<br>
<select class="cascade-street ea-triggers-bound" data-street-list="/HouseholdMember/StreetsForSuburb" id="PostalAddress_Street_ddl" name="PostalAddress.Street">
<option value="">-- Please select --</option>
</select>
<span class="field-validation-valid" data-valmsg-for="PostalAddress.Street" data-valmsg-replace="true"></span>
</p>
<p>
<label class="required-label control-label" for="PostalAddress_UnitStreetNo">Unit/Street number</label>
<br>
<input class="text-box single-line ea-triggers-bound" data-val="true" data-val-requiredif="The Unit/Street number field is required." data-val-requiredif-allowempty="false"
data-val-requiredif-expression=""IsUnitStreetNoRequired == true"" data-val-requiredif-fieldsmap="{"IsUnitStreetNoRequired":"bool"}" id="PostalAddress_UnitStreetNo" name="PostalAddress.UnitStreetNo"
type="text" value="">
<span class="field-validation-valid" data-valmsg-for="PostalAddress.UnitStreetNo" data-valmsg-replace="true"></span>
</p>
</div>
<div id="divPostalPoBox" style="display: none;">
<p>
<label class="required-label control-label" for="PostalAddress_PoBox">PO Box</label>
<br>
<input data-val="true" data-val-required="The Po Box field is required." id="PostalAddress_PoBox" maxlength="50" name="PostalAddress.PoBox" type="text" value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="PostalAddress.PoBox" data-valmsg-replace="true"></span>
</p>
</div>
</div>
</fieldset>
<script language="javascript" src="/Scripts/address.js"></script>
<script language="javascript">
$(document).ready(function() {
//debugger;
$("#divPostalPoBox").hide();
//$("#divPostalPoBoxRadio").hide();
contactType = $('[id="ContactType"]:checked').val(); // 1.Email 2.Phone 3.Mail
//when contact type is "Email" show required field indicator
if (contactType == 1) $("#email-required").show();
else $("#email-required").hide();
if ($("#PostalAddress_SuburbPostcode_quickselect") != null && $("#PostalAddress_SuburbPostcode_quickselect").val() != null) {
if ($("#PostalAddress_SuburbPostcode_quickselect").val().length >= 0) {
$("#PostalAddress_chkSameAddress").prop('disabled', true);
} else {
$("#PostalAddress_chkSameAddress").prop('disabled', false);
}
}
$("input[id=IsPostalPoBox][value=False]").prop('checked', 'checked'); //$("#IsPostalPoBox").prop('checked', false);
//alert($('[id="IsPostalPoBox"]:checked').val());
$("#PostalAddress_chkSameAddress").change(function() {
//debugger;
whatchanged = $(this).closest("div");
if (this.checked) {
$("#PostalAddress_SuburbPostcode_quickselect").val($("#PropertyAddress_SuburbPostcode_quickselect").val());
$("input[type='hidden'][name='PostalAddress.SuburbPostcode']").val($("#PropertyAddress_SuburbPostcode_quickselect").val());
StreetsCascadeWithTextParam($("#PostalAddress_SuburbPostcode_quickselect").val()).done(function(result) {
var selectedStreet = $("#PropertyAddress_Street_ddl").val()
$("#PostalAddress_UnitStreetNo").val($("#PropertyAddress_UnitStreetNo_Editor").val());
$("#PostalAddress_Street_ddl").val($("#PropertyAddress_Street_ddl").val());
});
} else {
$("#PostalAddress_SuburbPostcode_quickselect").val("");
$("#PostalAddress_Street_ddl").empty();
$("#PostalAddress_Street_ddl").html("<option>-- Please select --</option>");
$("#PostalAddress_UnitStreetNo").val("");
}
})
ToggleAddress();
})
function ToggleAddress() {
//debugger;
//infoUpdatePostalAddress = $("#chkPostalAddress").is(":checked");
//this if condition is when residential address is checked/selected
//if (infoUpdatePostalAddress == false) {
isPoBoxAddress = $('[id="IsPostalPoBox"]:checked').val();
if (isPoBoxAddress != null) {
if (isPoBoxAddress.toLowerCase() == "true") {
$("#divPostalStreetAddress").hide();
$("#divPostalPoBox").show();
$("input#IsUnitStreetNoRequired").val(false);
$("#divSameAddress").hide();
//$("#PostalAddress_SuburbPostcode_quickselect").val("");
//$("#PostalAddress_Street_ddl").empty();
//$("#PostalAddress_Street_ddl").html("<option>-- Please select --</option>");
//$("#PostalAddress_UnitStreetNo").val("");
} else {
$("#divPostalStreetAddress").show();
$("#divPostalPoBox").hide();
$("input#IsUnitStreetNoRequired").val(true);
$("#divSameAddress").show();
}
}
//}
//else condition is when postal address is checked/selected
//else {
// isPostalPoBoxAddress = $('[name="NewPostalAddresses.IsPoBox"]:checked').val();
// if (isPostalPoBoxAddress.toLowerCase() == "true") {
// $('[id="NewPostalAddresses_Street"]').hide()
// $('[for="NewPostalAddresses_Street"]').hide()
// $('[id="NewPostalAddresses_StreetRequiredFieldInidcator"]').hide()
// $('[id="NewPostalAddresses_RoomNo"]').hide()
// $('[for="NewPostalAddresses_RoomNo"]').hide()
// $('[id="NewPostalAddresses_UnitStreetNo"]').hide()
// $('[for="NewPostalAddresses_UnitStreetNo"]').hide()
// $('[id="NewPostalAddresses_PoBox"]').show()
// $('[for="NewPostalAddresses_PoBox"]').show()
// $('[for="NewPostalAddresses_PoBox"]').css('margin-top', -100);
// $("input#NewPostalAddresses.IsUnitStreetNoRequired").val(false);
// }
// else {
// $('[id="NewPostalAddresses_Street"]').show()
// $('[for="NewPostalAddresses_Street"]').show()
// $('[id="NewPostalAddresses_StreetRequiredFieldInidcator"]').show()
// $('[id="NewPostalAddresses_RoomNo"]').show()
// $('[for="NewPostalAddresses_RoomNo"]').show()
// $('[id="NewPostalAddresses_UnitStreetNo"]').show()
// $('[for="NewPostalAddresses_UnitStreetNo"]').show()
// $('[id="NewPostalAddresses_PoBox"]').hide()
// $('[for="NewPostalAddresses_PoBox"]').hide()
// $("input#NewPostalAddresses.IsUnitStreetNoRequired").val(true);
// }
//}
//}
//else {
// $("input#IsUnitStreetNoRequired").val(true);
//}
};
</script>
<div id="new-members">
<div class="new-member-row row">
<input type="hidden" name="AllHouseholdMembers.index" autocomplete="off" value="79c22333-cf56-480e-9307-09e16459c844" class="ea-triggers-bound">
<h2> Who has moved in?</h2>
<fieldset>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__FirstName">First name</label><abbr id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__FirstNameRequiredFieldInidcator" class="required"
aria-required="true">*</abbr>
<br>
<input data-val="true" data-val-required="The First name field is required." id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__FirstName" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].FirstName" type="text"
value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].FirstName" data-valmsg-replace="true"></span>
</p>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__LastName">Last name</label><abbr id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__LastNameRequiredFieldInidcator" class="required"
aria-required="true">*</abbr>
<br>
<input data-val="true" data-val-required="The Last name field is required." id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__LastName" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].LastName" type="text"
value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].LastName" data-valmsg-replace="true"></span>
</p>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__DOB">Date of birth</label><abbr id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__DOBRequiredFieldInidcator" class="required"
aria-required="true">*</abbr>
<br>
<input class="date-picker-birthday text-box single-line ea-triggers-bound" data-val="true" data-val-date="The field Date of birth must be a date." data-val-pastdate="Date of Birth should be in the past"
data-val-required="The Date of birth field is required." id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__DOB" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].DOB" type="date" value="">
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].DOB" data-valmsg-replace="true"></span>
</p>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__GenderId">Gender</label><abbr id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__GenderIdRequiredFieldInidcator" class="required"
aria-required="true">*</abbr>
<br>
<select data-val="true" data-val-number="The field Gender must be a number." data-val-required="The Gender field is required." id="Gender" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].GenderId" class="ea-triggers-bound">
<option value="">-- Please select --</option>
<option value="1">Female</option>
<option value="2">Male</option>
</select>
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].GenderId" data-valmsg-replace="true"></span>
</p>
<p>
</p>
<div class="indigenous-status-div">
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__IndigenousOrigins">Is this person an Aboriginal and/or Torres Strait Islander?</label><abbr
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__IndigenousOriginsRequiredFieldInidcator" class="required" aria-required="true">*</abbr>
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].IndigenousOrigins" data-valmsg-replace="true"></span>
<br>
<input data-val="true" data-val-number="The field Is this person an Aboriginal and/or Torres Strait Islander? must be a number." data-val-required="Indigenous Status field is required"
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__IndigenousOrigins" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].IndigenousOrigins" type="radio" value="1" class="ea-triggers-bound"><span> No</span>
<br>
<input id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__IndigenousOrigins" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].IndigenousOrigins" type="radio" value="2" class="ea-triggers-bound"><span>
Aboriginal</span>
<br>
<input id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__IndigenousOrigins" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].IndigenousOrigins" type="radio" value="3" class="ea-triggers-bound"><span> Torres Strait
Islander</span>
<br>
<input id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__IndigenousOrigins" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].IndigenousOrigins" type="radio" value="4" class="ea-triggers-bound"><span> Aboriginal
and Torres Strait Islander</span>
</div>
<p></p>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__DateMoveIn">When did they move in?</label><abbr id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__DateMoveInRequiredFieldInidcator"
class="required" aria-required="true">*</abbr>
<br>
<input class="date-picker text-box single-line ea-triggers-bound" data-val="true" data-val-date="The field When did they move in? must be a date." data-val-required="The When did they move in? field is required."
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__DateMoveIn" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].DateMoveIn" type="date" value="">
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].DateMoveIn" data-valmsg-replace="true"></span>
</p>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__BasicRelationshipId">What is their relationship to the legal tenant?</label><abbr
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__BasicRelationshipIdRequiredFieldInidcator" class="required" aria-required="true">*</abbr>
<br>
<select data-val="true" data-val-number="The field What is their relationship to the legal tenant? must be a number." data-val-required="The What is their relationship to the legal tenant? field is required."
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__BasicRelationshipId" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].BasicRelationshipId" class="ea-triggers-bound">
<option value="">-- Please select --</option>
<option value="1">Spouse/Partner</option>
<option value="2">Dependent (Son, Daughter)</option>
<option value="3">Resident (Friend, Relative)</option>
</select>
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].BasicRelationshipId" data-valmsg-replace="true"></span>
</p>
<div class="relationship-div">
<p> Is this person the partner or child of another household member (including other people you may have already added as part of this request)?<abbr class="required" aria-required="true">*</abbr>
<br>
<select class="additional-relationship-ddl ea-triggers-bound" data-val="true" data-val-number="The field Is this person the partner or child of another household member must be a number."
data-val-required="The Is this person the partner or child of another household member field is required." id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__AdditionalRelationshipId"
name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].AdditionalRelationshipId">
<option value="">-- Please select --</option>
<option value="4">No</option>
<option value="5">Yes, Spouse/Partner</option>
<option value="6">Yes, Dependent (Son, Daughter)</option>
</select>
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].AdditionalRelationshipId" data-valmsg-replace="true"></span>
</p>
<div class="sub-relationship-div" style="display: none;">
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__AdditionalRelationshipWho">What is their name</label><abbr
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__AdditionalRelationshipWhoRequiredFieldInidcator" class="requiredSpace"></abbr><abbr class="required" aria-required="true">*</abbr>
<br>
<input class="additional-relationship-who-txt ea-triggers-bound" data-val="true" data-val-requiredif="Related to name is required" data-val-requiredif-allowempty="false"
data-val-requiredif-expression=""AdditionalRelationshipId == 5 || AdditionalRelationshipId == 6"" data-val-requiredif-fieldsmap="{"AdditionalRelationshipId":"number"}"
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__AdditionalRelationshipWho" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].AdditionalRelationshipWho" type="text" value="">
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].AdditionalRelationshipWho" data-valmsg-replace="true"></span>
</p>
</div>
</div>
<div>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__OwnsProperty">Does the person moving in, own or part own any type of property in Australia or overseas? This includes residential (e.g. house,
unit, townhouse), commercial and industrial property, vacant land (rural and residential) and manufactured/transportable homes</label><abbr
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__OwnsPropertyRequiredFieldInidcator" class="requiredSpace"></abbr>
<br>
<input class="owns-property-rb ea-triggers-bound" data-val="true"
data-val-required="The Does the person moving in, own or part own any type of property in Australia or overseas? This includes residential (e.g. house, unit, townhouse), commercial and industrial property, vacant land (rural and residential) and manufactured/transportable homes field is required."
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__OwnsProperty" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].OwnsProperty" type="radio" value="True"> Yes <br>
<input checked="checked" class="owns-property-rb ea-triggers-bound" id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__OwnsProperty" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].OwnsProperty" type="radio"
value="False"> No <br>
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].OwnsProperty" data-valmsg-replace="true"></span>
</p>
<div class="owned-property-details-div" hidden="hidden">
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__AssetType">Asset type</label><abbr id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__AssetTypeRequiredFieldInidcator"
class="requiredSpace"></abbr>
<br>
<input id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__AssetType" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].AssetType" type="text" value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].AssetType" data-valmsg-replace="true"></span>
</p>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__AssetValue">Value of asset</label><abbr id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__AssetValueRequiredFieldInidcator"
class="requiredSpace"></abbr>
<br>
<input data-val="true" data-val-number="The field Value of asset must be a number." data-val-range="Value of asset should be between 0 and 10000000" data-val-range-max="10000000" data-val-range-min="0"
data-val-regex="Value of asset must be a dollar value" data-val-regex-pattern="^\$?[0-9]+(,[0-9]{3})*(\.[0-9]{2})?$" id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__AssetValue"
name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].AssetValue" type="text" value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].AssetValue" data-valmsg-replace="true"></span>
</p>
</div>
</div>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__NumberOfDays">How many days per week is this person staying in your home?</label><abbr
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__NumberOfDaysRequiredFieldInidcator" class="required" aria-required="true">*</abbr>
<br>
<input data-val="true" data-val-number="The field How many days per week is this person staying in your home? must be a number." data-val-range="Days per week be a value between 1 and 7" data-val-range-max="7" data-val-range-min="1"
data-val-required="Days per week is required" id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__NumberOfDays" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].NumberOfDays" type="text" value="0"
class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].NumberOfDays" data-valmsg-replace="true"></span>
</p>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__IncomeType">What type of income does this person receive (e.g. wages, pension, allowance, family payments)?</label><abbr
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__IncomeTypeRequiredFieldInidcator" class="requiredSpace"></abbr>
<br>
<input id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__IncomeType" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].IncomeType" type="text" value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].IncomeType" data-valmsg-replace="true"></span>
</p>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__WeeklyIncome">How much is their gross weekly income?</label><abbr
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__WeeklyIncomeRequiredFieldInidcator" class="requiredSpace"></abbr>
<br>
<input data-val="true" data-val-number="The field How much is their gross weekly income? must be a number." data-val-range="Total weekly income should be between 0 and 10000000" data-val-range-max="10000000" data-val-range-min="0"
data-val-regex="Total weekly income amount must be a dollar value" data-val-regex-pattern="^\$?[0-9]+(,[0-9]{3})*(\.[0-9]{2})?$" id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__WeeklyIncome"
name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].WeeklyIncome" type="text" value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].WeeklyIncome" data-valmsg-replace="true"></span>
</p>
<p>
<label class=" control-label" for="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__CRN">If the person receives a Centrelink payment, what is their Customer Reference Number (CRN)?</label><abbr
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__CRNRequiredFieldInidcator" class="requiredSpace"></abbr>
<br>
<input data-val="true" data-val-length="Centrelink number cannot exceed 10 characters in length" data-val-length-max="10" data-val-regex="Centrelink number must be in the correct format." data-val-regex-pattern="[0-9]{9}[a-zA-Z]"
id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__CRN" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].CRN" type="text" value="" class="ea-triggers-bound">
<span class="field-validation-valid" data-valmsg-for="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].CRN" data-valmsg-replace="true"></span>
</p>
<input data-val="true" data-val-required="The IsFirstRecord field is required." id="AllHouseholdMembers_79c22333-cf56-480e-9307-09e16459c844__IsFirstRecord" name="AllHouseholdMembers[79c22333-cf56-480e-9307-09e16459c844].IsFirstRecord"
type="hidden" value="True" class="ea-triggers-bound">
</fieldset>
</div>
<script src="/bundles/customhelpers?v=AMWnt0mq_NYkgIpRoZObzRhdvGRu3e3gns1qtZh0SRI1"></script>
<script language="javascript" type="text/javascript">
$(document).ready(function() {
$(".sub-relationship-div").hide();
$(".remove-member-button").click(function() {
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});
});
</script>
</div>
<em>
<button type="button" id="btnAddMember" class="btn btn-primary">Add another household member</button>
</em>
<h2>Current incomes for all household members</h2>
<p> You will need to provide evidence of the current income for all household members. You can attach the evidence to this form below, provide this at the your nearest
<a href="/Go/housing-service-centre-web" target="_blank">Housing Service Centre</a><small class="print-link-url"> ( https://housingselfservice.hpw.qld.gov.au/Go/housing-service-centre-web )</small> or send in by email. </p>
<p> (Maximum file size: 10 MB. Preferred file types: PDF, Jpeg, GIF, TIFF) </p>
<p>
</p>
<ol class="questions">
<li>Files currently attached: </li>
<span class="field-validation-valid" data-valmsg-for="Files" data-valmsg-replace="true"></span>
<li>
<div id="addAttachmentRows" class="addAttachmentRows">
<ul class="actions noPrint">
<li>
<em>
<button type="button" id="btnAddAttachments" class="btn btn-primary add-attachment noPrint">Add attachment</button>
</em>
</li>
</ul>
</div>
</li>
</ol>
<p></p>
<script language="javascript" src="/Scripts/files.js"></script>
<p>
<span class="field-validation-valid" data-valmsg-for="Declaration" data-valmsg-replace="true"></span><br>
<input data-val="true" data-val-range="You have to accept the declaration." data-val-range-max="True" data-val-range-min="True"
data-val-required="The I am a legal tenant (person who signed the State tenancy agreement) and have read and understood the following privacy notice and Declaration field is required." id="Declaration" name="Declaration" type="checkbox"
value="true" class="ea-triggers-bound"><input name="Declaration" type="hidden" value="false" class="ea-triggers-bound">
<label for="Declaration">I am a legal tenant (person who signed the State tenancy agreement) and have read and understood the following privacy notice and Declaration</label>
</p>
<hr>
<p style="font:small-caption"><b>Personal Information Privacy Notice</b></p>
<p style="font-size:12px"> The Department of Housing and Public Works is collecting personal information on this form to provide you with housing assistance or assess grant funding applications. This is authorised by the Housing Act 2003. To assist
you with your housing needs and services, relevant personal information may, in very limited and specific circumstances, be disclosed to: partner agencies, service providers, agencies authorised by legislative provisions, and local governments
and non-governmental agencies that now, or will provide you with housing and/or support services. Limited personal information may be used for housing related research, policy or planning functions. Unless authorised or required by law, your
personal information will not be passed on to any other third party without your consent. More information about the department’s privacy policy is available on our website at
<a href="http://www.hpw.qld.gov.au" target="_blank">www.hpw.qld.gov.au</a><small class="print-link-url"> ( http://www.hpw.qld.gov.au/ )</small>. </p>
<p style="font:small-caption"><b>Declaration</b></p>
<p style="font-size:12px">I confirm the information submitted is true and correct. I acknowledge that it is an offence under the Housing Act 2003 to knowingly give false or misleading information to the department that may influence decisions about
the provision of housing services to me.</p>
<p style="font:small-caption"><b>Disclaimer</b></p>
<p style="font-size:12px">While the department will make every effort to provide assistance, completing this form does not guarantee that the department will be able to provide the assistance you require. </p>
<p>
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<button type="submit">Submit</button>
</strong>
</p>
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</form>POST https://www.smartservice.qld.gov.au/services/submissions/email/feedback/feedback
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</form>Text Content
SKIP LINKS AND KEYBOARD NAVIGATION
* Skip to content
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SITE HEADER
* Contact us
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* For Queenslanders
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YOU ARE HERE:
1. Queensland Government home
2. For Queenslanders
3. Homes and housing
4. Public and community housing
5. Public housing tenants
6. During your tenancy
7. Tenant self-service
8. Add household member
ADD HOUSEHOLD MEMBER
Use this form to let us know that one or more people have moved into your
property. All household members must be approved by the department to move into
your home. We will conduct a full rent review, so you will need to provide
current income details for all household members. You can either attach the
documents when submitting this request or send them to your nearest Housing
Service Centre (
https://housingselfservice.hpw.qld.gov.au/Go/housing-service-centre-web ).
*
YOUR PERSONAL DETAILS
Rental agreement number*
First name
Last name
Date of birth (e.g. 12/06/1971)
How can we contact you?
Email
Phone
Mail
Email address*
(You must provide at least one contact number)
Phone number
Mobile number
YOUR ADDRESS
If you cannot find your suburb by name, please enter your postcode. If there is
no match, please contact your nearest Housing Service Centre (
https://housingselfservice.hpw.qld.gov.au/Go/housing-service-centre-web )
Suburb or postcode
Street
-- Please select --
Unit/Street number
PO Box
YOUR POSTAL ADDRESS
PO Box
Street address
Same as above
Suburb or postcode*
Street
-- Please select --
Unit/Street number
PO Box
WHO HAS MOVED IN?
First name*
Last name*
Date of birth*
Gender*
-- Please select -- Female Male
Is this person an Aboriginal and/or Torres Strait Islander?*
No
Aboriginal
Torres Strait Islander
Aboriginal and Torres Strait Islander
When did they move in?*
What is their relationship to the legal tenant?*
-- Please select -- Spouse/Partner Dependent (Son, Daughter) Resident (Friend,
Relative)
Is this person the partner or child of another household member (including other
people you may have already added as part of this request)?*
-- Please select -- No Yes, Spouse/Partner Yes, Dependent (Son, Daughter)
What is their name*
Does the person moving in, own or part own any type of property in Australia or
overseas? This includes residential (e.g. house, unit, townhouse), commercial
and industrial property, vacant land (rural and residential) and
manufactured/transportable homes
Yes
No
Asset type
Value of asset
How many days per week is this person staying in your home?*
What type of income does this person receive (e.g. wages, pension, allowance,
family payments)?
How much is their gross weekly income?
If the person receives a Centrelink payment, what is their Customer Reference
Number (CRN)?
Add another household member
CURRENT INCOMES FOR ALL HOUSEHOLD MEMBERS
You will need to provide evidence of the current income for all household
members. You can attach the evidence to this form below, provide this at the
your nearest Housing Service Centre (
https://housingselfservice.hpw.qld.gov.au/Go/housing-service-centre-web ) or
send in by email.
(Maximum file size: 10 MB. Preferred file types: PDF, Jpeg, GIF, TIFF)
1. Files currently attached:
2. * Add attachment
I am a legal tenant (person who signed the State tenancy agreement) and have
read and understood the following privacy notice and Declaration
--------------------------------------------------------------------------------
Personal Information Privacy Notice
The Department of Housing and Public Works is collecting personal information on
this form to provide you with housing assistance or assess grant funding
applications. This is authorised by the Housing Act 2003. To assist you with
your housing needs and services, relevant personal information may, in very
limited and specific circumstances, be disclosed to: partner agencies, service
providers, agencies authorised by legislative provisions, and local governments
and non-governmental agencies that now, or will provide you with housing and/or
support services. Limited personal information may be used for housing related
research, policy or planning functions. Unless authorised or required by law,
your personal information will not be passed on to any other third party without
your consent. More information about the department’s privacy policy is
available on our website at www.hpw.qld.gov.au ( http://www.hpw.qld.gov.au/ ).
Declaration
I confirm the information submitted is true and correct. I acknowledge that it
is an offence under the Housing Act 2003 to knowingly give false or misleading
information to the department that may influence decisions about the provision
of housing services to me.
Disclaimer
While the department will make every effort to provide assistance, completing
this form does not guarantee that the department will be able to provide the
assistance you require.
Submit
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