What should a Statutory Declaration for a Replacement Exemption include?

This is a FAQ BLOG and you can refer to our 19AB & IMGs | DWS / DPA | 10 Year Moratorium | 19AB Exemptions blog here.
In order to apply for a Replacement 19AB Exemption, the leaving doctor will need to sign a statutory declaration stating that they have closed their provider number for that location and that they are leaving the catchment area and will not be using a Medicare provider number that has been issued to them in that catchment area until their 10 year moratorium has ceased.
Please note that a statutory declaration or written undertaking is acceptable from a departing doctor, and is a requirement for a new doctor to be considered under the replacement provision.
Note: The information presented above has been gathered from email enquiries with AHPRA and has been updated as of 2023-08-16.
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