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Step 1 of 7
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Please Read
You must be a registered beneficiary of the Tūwharetoa Māori Trust Board before applying for this grant.
Not Registered?
APPLY NOW
The Kaumatua Medical Grants are only paid to Kaumatua aged 60 years and over.
Kaumātua Medical Grants are only available for beneficiariess living in Aotearoa New Zealand.
This grant is
open
from the
1st of July to the 30th of June
for each year. Grants are processed every month and applications must be
recieved by the 10th
of each month for
payment on the 20th
of each month.
Medical grants are paid for the following categories:
* $200 Travel
* $500 Eye Treatment
* $1,000 Dental Treatment
* $1,000 Hearing Treatment
Grants are only paid when a
copy
of the
PAID ACCOUNT
and/or
QUOTE
is received.
The Tūwharetoa Māori Trust Board reserves, without further enquiry, the right to decline any application not properly completed and/or containing inaccurate details or information not to its satisfaction.
SECTION 1: PERSONAL DETAILS
Beneficiary Number
*
This is a six digit number. Please contact the office for your beneficiary number.
First Name
*
Middle Name
*
Last Name
*
Date
*
To be eligible for a Kaumātua Medical Grant you must be 60 years and over.
Address
*
Address
City
Posta Code
Phone Number
*
Email Address
*
Enter Email
Confirm Email
Are you completing this form on someone elses behalf ?
*
Yes
No
Relationship of Caregiver to Applicant (select one):
*
Parent
Grandparent
Other
Please enter your relationship to the Applicant
*
Signature
*
SECTION 2: TREATMENT CATEGORY
Please select one:
*
$200 Travel
$500 Eye treatment
$800 Specialist (surgery)
$1,000 Dental treatment
$1,000 Hearing treatment
SECTION 3: MEDICAL DETAILS
Name of Practitioner
*
Address
*
Phone Number
*
Cost of Treatment
*
Date of Treatment
SECTION 4: BANK ACCOUNT DETAILS
Name of Bank
*
Account Name
*
Bank Account Number
*
Please note: if the suffix (the last numbers) of your bank account has only two digits please enter the third digit as a '0'
SECTION 5: SUPPORTING DOCUMENTS
Please attach the following documents:
Verification of Medical Treatment:
*
* Copy of a paid Account or Quote.
Drop files here or
Accepted file types: pdf, doc, docx, png, jpg, jpeg, gif.
Bank Account Verification:
*
* A verified bank deposit slip or statement.
Drop files here or
Accepted file types: pdf, doc, docx, png, jpg, jpeg, gif.
You cannot complete this registration unless you provide all required information
Declaration
Yes I confirm all information provided is true and correct
*
Yes
No
Name
This field is for validation purposes and should be left unchanged.
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