Forms

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

What's happening with your claim
We're currently working to finalise a large number of claims. An update on our progress.

Application formNumber
Appeal against Review Decision  
Appointment of a Representative  VA55
Approved Travel for Assessments, Treatment, Rehabilitation  VA23
Certificate of Appreciation and Lapel Badge  
Change of Circumstances  VA52
Childcare payment for Children of a Deceased Veteran (Scheme Two)  VA48
Children’s Bursary  VA08
Children’s Pension  VA06
Dependant’s Pension  VA07
Disablement Pension  VA01
Disablement Pension and Lump Sum Payment Maximum rate for terminal condition  VA03
Employment and Earnings Declaration  VA51
Financial Advice  VA49
Funding for Commemorative Event or Project  VA24
Funding for Commemorative Travel  VA20
Funeral Expenses  VA14
Independence Allowance Lump Sum (Scheme Two)  VA34
Individual Care Plan for Audiologists  
Memorial Contribution (Plaque or Headstone)  VA29B
Memorial Order Form (Plaque or Headstone)  VA29A
New Conditions and Reassessment of Accepted Disabilities  VA02
Personal Information and Consent Form  
Private Hospital Surgery  VA26
Reconsider Decision  VA15
Registration of Deceased Spouses and Partners of Viet Nam Veterans’  
Registration of Deceased Viet Nam Veterans  
Registration of the Deceased Children of Viet Nam Veterans’  
Registration of Viet Nam Veterans  
Registration of Viet Nam Veterans’ Children and Grandchildren  
Registration of Viet Nam Veterans’ Spouses and Partners  
Retirement Lump Sum  VA13
Review of Decision  VA16
Statutory Declaration  
Surviving Spouse or Partner Pension  VA05
Surviving Spouse or Partner Pension—New Relationship (Scheme One)  VA18
Survivor’s Grant and Weekly Compensation  VA47
Terminal Condition Maximum rate of Disablement Pension and Lump Sum Payment  VA03
Transfer to a Disablement Pension  VA01A
Travel Concession Payment   VA40
Travel Concession Dispensation from the Normal Evidential Requirements  
Travel—Long Term Hospital Care  VA33
Travel Statutory Declaration  
Treatment and Rehabilitation  VA30
Treatment Expenses  VA22
Veteran Support (Scheme Two)  VA44
Viet Nam Veterans Annual Medical Assessment (AMA)  
Weekly Compensation (Scheme Two)  VA11
Weekly Income Compensation VA04