Forms

Forms for our clients, family and whānau, and our providers.

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Application form Number
Appeal against Review Decision [PDF, 397 KB]  
Appointment of a Representative [PDF, 276 KB]  VA55
Approved Travel for Assessments, Treatment, Rehabilitation [PDF, 276 KB]  VA23
Certificate of Appreciation and Lapel Badge [PDF, 265 KB]  
Change of Circumstances [PDF, 316 KB]  VA52
Childcare payment for Children of a Deceased Veteran (Scheme Two) [PDF, 364 KB]  VA48
Children’s Bursary [PDF, 494 KB]  VA08
Children’s Pension [PDF, 514 KB]  VA06
Dependant’s Pension [PDF, 527 KB]  VA07
Disablement Pension [PDF, 496 KB]  VA01
Disablement Pension and Lump Sum Payment Maximum rate for terminal condition [PDF, 541 KB]  VA03
Employment and Earnings Declaration [PDF, 309 KB]  VA51
Financial Advice [PDF, 290 KB]  VA49
Funding for Commemorative Event or Project [PDF, 510 KB]  VA24
Funding for Commemorative Travel [PDF, 518 KB]  VA20
Funeral Expenses [PDF, 730 KB]  VA14
Independence Allowance Lump Sum (Scheme Two) [PDF, 247 KB]  VA34
Individual Care Plan for Audiologists [PDF, 223 KB]  
Memorial Contribution (Plaque or Headstone) [PDF, 504 KB]  VA29B
Memorial Order Form (Plaque or Headstone) [PDF, 496 KB]  VA29A
Personal Information and Consent Form [PDF, 248 KB]  
Private Hospital Surgery [PDF, 272 KB]  VA26
Reconsider Decision [PDF, 377 KB]  VA15
Registration of Deceased Spouses and Partners of Viet Nam Veterans’ [PDF, 85 KB]  
Registration of Deceased Viet Nam Veterans [PDF, 94 KB]  
Registration of the Deceased Children of Viet Nam Veterans’ [PDF, 90 KB]  
Registration of Viet Nam Veterans [PDF, 92 KB]  
Registration of Viet Nam Veterans’ Children and Grandchildren [PDF, 89 KB]  
Registration of Viet Nam Veterans’ Spouses and Partners [PDF, 81 KB]  
Retirement Lump Sum [PDF, 447 KB]  VA13
Review of Decision [PDF, 351 KB]  VA16
Statutory Declaration [PDF, 209 KB]  
Surviving Spouse or Partner Pension [PDF, 719 KB]  VA05
Surviving Spouse or Partner Pension—New Relationship (Scheme One) [PDF, 309 KB]  VA18
Survivor’s Grant and Weekly Compensation [PDF, 345 KB]  VA47
Transfer to a Disablement Pension [PDF, 313 KB] VA1A
Travel Concession Payment [PDF, 255 KB]   VA40
Travel Concession Dispensation from the Normal Evidential Requirements [PDF, 131 KB]  
Travel—Long Term Hospital Care [PDF, 262 KB]  VA33
Travel Statutory Declaration [PDF, 218 KB]  
Treatment and Rehabilitation [PDF, 380 KB]  VA30
Treatment Expenses (other) [PDF, 472 KB]  VA22B
Treatment Expenses (vet) [PDF, 454 KB] VA22A
Veteran Support [PDF, 362 KB] VA56
Viet Nam Veterans Annual Medical Assessment (AMA) [PDF, 511 KB]  
Weekly Income Compensation [PDF, 800 KB] VA04

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