Aged care request for a nominee for Department of Veterans’ Affairs customers form (AC019)

Use this form to choose another person or organisation to deal with us on your behalf for aged care costs if you’re a Department of Veterans’ Affairs customer.

You must download our forms to fill them in. We have help available if you use assistive technology or if you need a translator or interpreter. Find out how to use our forms.

You can do this if both the following apply:

  • you get a Department of Veterans’ Affairs payment
  • you live in an aged care home or get Support at Home services.

The person you authorise is known as a nominee.

Download and complete the Aged Care Request for a nominee for Department of Veterans’ Affairs customers form.

Page last updated: 21 November 2025.
QC 19911