Form C1 - Application For Concession - Western Australia Department Of Transport
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Government of Western Australia
Department of Transport
Application for Concession
The information you supply on this form will be used to confirm your entitlement to a concession. With legislative authority, the information on
this form may be disclosed to other government agencies. The Chief Executive Officer of the Department of Transport also releases aggregated
statistical information to third parties. However, your personal identifying information will not be released to these persons without your explicit
consent. See the General Information on the back of the form for where you can present this form.
If your concession entitlement is reduced or withdrawn, you must notify the Department of Transport immediately. If you continue to claim
concession rates on a vehicle and you are no longer entitled to that concession, the vehicle licence will be deemed invalid. The continued
use of the vehicle on any road will be in contravention of the Road Traffic (Vehicles) Act 2012. You may be fined, required to pay additional
penalties and your vehicle may not be insured.
CONCESSION APPLICATION TYPE
CONCESSION INFORMATION
VEHICLE LICENCE CONCESSION
VEHICLE LICENCE
The appropriate pensioner concession card and/or letter from the pension
Concession can only be applied to one vehicle at one time.
provider must be produced for you to be eligible for a concession.
Below is a list of the documentation that must be presented when making
DRIVER’S LICENCE
application for a motor vehicle licence concession.
APPLICANT DETAILS
Veterans’ Affairs concessions - if you are applying for a refund you may
be required to provide a letter from Veterans’ Affairs confirming the date of
FAMILY NAME
grant.
THE MOTOR VEHICLE LICENCE CONCESSION APPLIES TO ONLY
ONE OF THE FOLLOWING:
FIRST NAME
1. a car or bus with an unloaded mass not exceeding 3000 kg;
2. a goods vehicle with an unloaded mass not exceeding 3000 kg;
OTHER NAME/S
3. a motor home;
4. a motor cycle; or
5. a moped as defined in the Road Traffic (Authorisation to Drive)
DATE OF BIRTH
Regulations 2008.
/
/
100% Concession
PHONE NUMBER
To be eligible for a 100% vehicle licence fee concession (exemption) and
exemption from vehicle licence duty you must hold one of the following:
EMAIL ADDRESS
•
Letter from Veterans’ Affairs or Centrelink stating you are receiving the
RESIDENTIAL ADDRESS
maximum rate of pension and one of the following:
• Veterans’ Affairs Service Invalid Pension Card; or
• Centrelink Pensioner Card (blind); or
• Centrelink Disability Support Pension Card; or
• Centrelink Pensioner Card (carer).
SUBURB
Or one of the following:
•
Letter from Veterans’ Affairs certifying the applicant has been
W A
STATE
POST CODE
assessed at 60 or more impairment points.
•
Veterans’ Affairs Gold DVA Health Card endorsed TPI.
CONCESSION DETAILS
•
Veterans’ Affairs Gold DVA Health Card endorsed EDA.
50% Concession
PENSIONER CONCESSION CARD
Card number
To be eligible for a 50% vehicle licence fee concession you must hold one
of the following:
Date of grant
Expiry date
•
Centrelink Pensioner Concession Card;
•
Veterans’ Affairs Pensioner Concession Card; or
VETERANS CONCESSION CARD
•
WA Seniors Card and Commonwealth Seniors Health Card (both
Card number
cards must be presented).
DRIVER’S LICENCE CONCESSION
Date of grant
Expiry date
100% Concession
COMMONWEALTH SENIORS HEALTH CARD
To be eligible for a 100% concession on your driver’s licence you must
present one of the following cards:
Card number
•
Centrelink Aged Pensioner Concession Card;
Date of grant
Expiry date
•
WA Seniors Card and Commonwealth Seniors Health Card (both cards
must be presented);
WA SENIORS CARD (Driver’s licence only)
•
Veterans’ Affairs Pensioner Concession Card (where the holder is
Card number
receiving a service pension and is of pension age. Please contact the
Department of Veterans’ Affairs for more information); or
Date of grant
Expiry date
•
Veterans’ Affairs Gold DVA Health Card endorsed TPI or EDA.
50% Concession
I declare that the information on this form is true and correct.
To be eligible for a 50% concession on your driver’s licence you must
I understand that under the Road Traffic (Administration) Act 2008, it is
present one of the following cards:
an offence to provide false or misleading information. I consent to checks
being carried out to confirm my ongoing entitlement to concessions, and
•
Any other Centrelink Pensioner Concession Card;
will report any changes to my eligibility.
•
WA Seniors Card; or
•
Veterans’ Affairs Pensioner Concession Card (where the holder is
pension.
receiving a service pension and has not yet reached pension age).
I declare that I am in receipt of the
Please contact the Department of Veterans’ Affairs for more information.
SIGNATURE OF APPLICANT
Photo Card Concession
The concession on your driver’s licence will be applied to your future photo card
applications.
/
/
DATE
Last updated: 05.12.2017
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