Individual exception application form

Electronic payment of gap fee

This form is for providers applying for an individual to pay by means other than electronic funds transfer (EFT).

This form must be completed by a person with management or control (PMC) of a provider.

The PMC completing this form must:

  • have consent from the individual to apply on their behalf
  • give the individual a copy of the individual privacy statement
  • ensure the individual has read and understood the individual privacy statement
  • ensure the individual has given consent to provide their personal information
  • read and understand the PMC privacy statement

The privacy statements are available on this application form and also on our website:

From 1 July 2023, families using child care must pay the gap fee using electronic means, or EFT. The gap fee is the difference between the provider’s fee and the Child Care Subsidy (CCS) amount.

More information about electronic payment of gap fees is available on the Australian Government Department of Education (the department) website.

This form is for providers who wish to apply for an exception on behalf of an individual so that the individual can pay by means other than EFT.

An individual may be eligible for an exception if they reasonably fear that paying the gap fee using EFT would put them or their child at risk of family or domestic violence.

Providers must include evidence regarding the exceptional circumstance.

Types of evidence that may be acceptable are:

  • letters or statements
  • referrals
  • case plans
  • certificate or determination for Additional Child Care Subsidy (child wellbeing) if granted for family or domestic violence reasons

Evidence must be from a suitable third-party organisation or professional, such as:

  • early intervention and support programs and services
  • state and territory government child safety/protection agencies
  • medical practitioners
  • welfare agency personnel and social workers
  • police officers

The third-party should be independent to the provider and service.

Where an immediate exception is required and a provider cannot gather relevant evidence, or is experiencing delays in gathering relevant evidence, a statutory declaration from the provider outlining the circumstances may be considered.