Claim for Bereavement Payment form (FA008M)
This form contains two sections - notes and claim form. This form is used if you are claiming Parental Leave Pay, Baby Bonus, Maternity Immunisation Allowance and/or Family Tax Benefit for a child you are not already receiving payment for who has recently died. In cases of stillbirth and infant death, your maternity hospital or registered midwife will provide you with a different version of this form, which will include a declaration for your attending doctor or midwife to complete.
- Claim for Bereavement Payment Form [pdf, 408kb]