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...Po box west perth wa t f application for payment country callers hi myleave gov au of long service leave www part to be completed by employee claiming on own behalf or the personal representative a deceased please use block letters details last name first names postal address suburb post code date birth phone registration number email if you are registered in another state states bank account provide following list them branch no eg aa smith this must your joint including note have interstate entitlements they will paid out one lump sum reason claim tick appropriate boxes show i wish apply weeks am aware that cannot work while penalties day b working director and supplied copies payg recent pay slips corresponding statements c finishing finished site with my employer entitlement see d longer an eligible job construction industry treated as termination means break purposes further years days before qualify lodged any earlier than week which finish spouse defacto partner executor estate ...