Transcription of Accommodation Supplement Application form S01
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Page 1 S01 APR 2020 Write your Client number here. It can be found on your Community Services Card or SuperGold number Tell us your detailsWhat is your full name?First and middle namesSurname or family nameWhat date were you born?DayMonthYearTell us how we can contact youHOW TO ANSWER Q3:If you live in a rural area, flat/house number could include your RAPID number, fire number, emergency services TO ANSWER Q4:Mailing address can include a PO Box, rural delivery details, or C/O TO ANSWER Q5:Please only give uscontact details you d like us to do you live?Flat/House numberStreet nameSuburbTown/CityIs your mailing address different from where you live?
Accommodation Supplement helps with rent, board, or home ownership costs. If you pay rent to Kāinga Ora or a community housing provider, you won’t be able to get an Accommodation Supplement. Accommodation Supplement application form
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