AIP Month 12 Claim Form

First Name *

Last Name *

Date of Birth *

Mobile *

Email *

CITB Number *

Please provide the below details of the bank account you wish to have your Apprentice Incentive Payment paid into.

BSB *

Account Number *

Account Name *

Usually the name of the person who holds this bank account

Bank *

Name of the bank the account is with e.g. Bank SA or ANZ

Declarations: *

I understand that CITB will seek to recover any payment made that is not compliant with funding criteria.

Checkboxes *

I am still in an active training contract and have not withdrawn or terminated at the time of submitting this form.

Checkboxes *

I understand that I need to complete the first 12 months of my Training Contract before I receive this payment.

Checkboxes *

I understand that I am responsible for submitting my application for each claim I am eligible for.

Checkboxes *

I have provided the correct bank account details and understand that any incorrect bank details may result in a rejected payment.

Checkboxes *