Change Of Details

Please complete all required fields and include documentary evidence as indicated.

Which of the following best describes you?(Required)

I am a current member of the Multi Purpose Taxi Program

I am an Authorised Person acting on behalf of a member of the Multi Purpose Taxi Program

Authorised person

Authorised person's name(Required)

First Last

Authorised person's address(Required)

Address Line 1 Address Line 2 City State / Territory Postcode Country

Authorised person's phone(Required)

Authorised person's email(Required)

Authorised person's relationship to member(Required)

To verify your status as an Authorised Person, please upload one of the following documents. If any document being provided is not in English, a certified translation of it into English must be provided.

A signed authorisation from the MPTP member granting permission for you to act on their behalf.
Power of Attorney: A copy of the power of attorney/guardianship order document.
Dependent Child/Minor: A copy of a birth certificate or current Medicare card or current Centrelink issued concession or health care card that states both the applicant’s name and your name.
Statutory Declaration: A statutory declaration outlining your relationship to the applicant, the basis of the authority given and scope of authorised activities.

Upload your document/s below(Required)

Accepted file types: pdf, png, jpg, jpeg, Max. file size: 50 MB.

Member details

MPTP member number or card number(Required)

Member's name(Required)

First Last

Member's date of birth(Required)

Member's phone(Required)

Member's address(Required)

Address Line 1 Address Line 2 City State / Territory Postcode Country

Member's email(Required)