Notification of Change of Circumstances for counter and telephone use

Form ID
DVA Staff

This form is used to collect information about changes to financial circumstance from pensioners when being interviewed via the telephone or at DVA counters.

If you are using an Apple computer and want to fill out your form electronically, please download the form and open it with Acrobat 7 or later.

How can I access this form?
Form (PDF or Word)