Aged Care Forms

Nominee Appointment Form

Nominee Appointment form for residential aged care recipients.

The Department of Health and Ageing has produced a new Nominee Appointment form. This form should be used by residents in Commonwealth funded hostels and nursing homes who wish to authorise another person to deal with the Department on their behalf. This form should also be used for residents who are mentally impaired and therefore unable to administer their own affairs.

If you are in residential aged care, you may authorise another person (a 'nominee') to deal with the Australian Government Department of Health and Ageing ('the Department') on your behalf. The nominee may receive information from the Department about your care costs and may give the Department information about your income and assets. If you decide not to appoint a nominee, the Department will contact you directly about these matters. You may vary or cancel the appointment of a nominee at any time, by writing to the Department.

You may download this document in PDF format:

PDF printable version of the Appointment of a Nominee Form (PDF 279 KB)

Need help? Call the Aged Care Information Line on 1800 500 853.

If you are unable to download the PDF file please send an email to: acc@health.gov.au for a copy to be sent to you.
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