Form C1 - Application For Concession - Western Australia Department Of Transport Page 2
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1
2GENERAL INFORMATION
This form may be presented at Driver and Vehicle Services (DVS) centres, regional Department of Transport offices or DVS agents.
Please visit our website at for location information. Alternatively, it can be posted along with certified/
witnessed copies of the front and back of your concession cards and any other documentation relevant to you to: Driver and Vehicle
Services, GPO Box R1290, Perth WA 6844.
Anyone certifying/witnessing your concession cards must qualify or currently be employed in one of the following professional or occupational groups:
Post Office Manager
1.
Academic (Post-Secondary Institution)
17.
Commonwealth Industrial Organisation Secretary
33.
2.
Accountant
18.
Insurance Broker
34.
Psychologist
3.
Architect
19.
Justice of the Peace
35.
Public Notary
Australian Consular Officer
4.
20.
Lawyer
36.
Public Servant (State or Commonwealth)
Australian Diplomatic Officer
5.
21.
Local Government CEO or Deputy CEO
37.
Real Estate Agent
6.
Bailiff
22.
Local Government Councillor
38.
Settlement Agent
7.
Bank Manager
23.
Loss Adjuster
39.
Sheriff or Deputy Sheriff
8.
Chartered Secretary
24.
Marriage Celebrant
40.
Surveyor
9.
Chemist
25.
Member of Parliament
41.
Teacher
Tribunal Officer
10. Chiropractor
26.
42.
Minister of Religion
11. Company Auditor or Liquidator
27.
Nurse
43.
Veterinary Surgeon
12. Court Officer
28.
Optometrist
44.
Any other authorised person under the
13. Defence Force Officer
Statutory Declarations Act 1959 of the
29.
Patent Attorney
14. Dentist
30.
Physiotherapist
Commonwealth
15. Doctor
31.
Podiatrist
Police Officer
16. Engineer
32.
OFFICE USE ONLY
Vehicle licence concession checklist
Driver’s licence concession checklist
Social 100% concessions Code 411
Social 100% c
oncessions
Letter from Veterans’ Affairs or Centrelink stating the
Age Pensioner Concession Code (A)
applicant is receiving the maximum rate of pension and
Veteran Age Pensioner Concession Code (V)
one of the following:
Veterans’ Affairs Service Invalid Pension Card
Veterans’ Affairs DVA Gold Health Card Code (V)
Centrelink Pensioner Card (Blind)
WA Seniors Card and Commonwealth Seniors Health Card
(both cards must be presented) (H)
Centrelink Disability Support Pensioner Card
Centrelink Pensioner Card (Carer)
Photocopy of card(s) attached
Photocopy of card(s) attached
Social 50% concessions
Or one of the following:
Letter from Veterans’ Affairs certifying the applicant has
Pensioner concession (P)
been assessed at 60 or more impairment points
Veteran Pension concession Type (P)
Veterans’ Affairs Gold DVA Health Card endorsed TPI
Veterans’ Affairs Gold DVA Health Card endorsed EDA
WA Seniors Card presented (S)
Photocopy of cards/documents attached
Photocopy of card(s) attached
Social 50% concessions Code 412
Centrelink Pensioner Concession Card
Veterans’ Affairs Pensioner Concession Card
WA Seniors Card and Commonwealth Seniors Health
Card (both cards must be presented)
Photocopy of card(s) attached
OPERATOR NAME
SITE
SIGNATURE
DATE
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