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Social Security

Fill Out Special Benefit Claim (SU004) Online

Claim for Special Benefit form

Services Australia

Paper claim for Special Benefit for people in severe financial hardship who cannot get another income support payment.

Reviewed July 2026

How it works

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    Open the form. The official PDF loads straight into the editor, no download needed first.

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    Fill it out in the editor. Click anywhere to type, add checkmarks and place your signature.

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    Download your PDF. Save the completed form, ready to print or submit.

Form SU004 is the paper claim for Special Benefit, a Centrelink income support payment for people in financial hardship due to circumstances beyond their control who cannot get another income support payment. The claim runs to 27 pages plus notes and gathers your personal, residence, income, assets, and accommodation details so Services Australia can assess your situation.

You can fill out SU004 directly in the Universal PDF editor. Type your answers into each question, review the checklist of supporting documents, then download the completed PDF to print and sign by hand before lodging it. If you have a myGov account linked to Centrelink, the agency notes that claiming online is faster and easier than the paper route.

What is Form SU004 used for

The form claims Special Benefit, which exists as a payment of last resort within the social security system. Because there is no single qualifying event, the claim asks you to describe your circumstances and why you are applying, then works through detailed questions about residence history, visa status, family situation, income, assets, and housing so a decision maker can assess hardship and eligibility.

The claim also lets you set up practical arrangements at the same time, including an interpreter preference, a nominee authority through the separate SS313 form, and the bank account your payment would go into if granted.

Who claims with Form SU004

To qualify for Special Benefit you must be in financial hardship, be unable to earn a sufficient livelihood for yourself and your dependants because of age, disability, domestic circumstances, or another reason outside your control, and not be receiving or entitled to another income support payment or a Service Pension from the Department of Veterans' Affairs, or any other ongoing support.

You must also be an Australian resident or hold an approved visa, and be residing in Australia at the date of claim and during payment, apart from limited exceptional circumstances. A claim on behalf of a child who is an Australian citizen or permanent resident uses a different form, SU721, not SU004.

How to fill out Form SU004

Set aside time, since this is one of the longer Centrelink claims. Work through it in order:

  • Enter your Customer Reference Number, name, date of birth, gender, addresses, and contact details, plus any other names you have been known by.
  • Describe your circumstances and why you are applying, which is the core hardship question of the claim.
  • Complete the residence section, including citizenship, country of birth, visa subclass and grant dates, and travel history.
  • Answer the income, assets, and accommodation questions for you and, where relevant, your partner.
  • Provide bank account details for payment. The account must be in your name, and joint accounts are acceptable.
  • Work through the checklist of documents, then sign and date the claim. Your partner signs as well where required.

How to submit it

Return the signed claim and supporting documents online through your Centrelink online account (identity documents excluded), by post to Services Australia, Centrelink, PO Box 7800, Canberra BC ACT 2610, or in person at a service centre.

If you can use online services, you can claim Special Benefit entirely online instead: sign in to myGov, select Payments and claims, then Make a claim, and apply under Other payments. Identity documents may still need to be shown separately.

Frequently asked questions

Yes. Services Australia recommends claiming through your Centrelink online account in myGov, under Payments and claims, then Make a claim. The paper form suits people who cannot use the online service.

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