Bereavement Declaration form (FA008M)

Use this form if you are the birth mother or partner of the birth mother, and you want to claim payments for a child who was stillborn or who has recently died.

You can claim Parental Leave Pay and Family Tax Benefit online. Find out more about claiming Family Tax Benefit and Parental Leave Pay. You can also read about Centrelink online accounts.

If you can’t claim online, download and complete the Notes and Claim for Bereavement Payment of Parental Leave Pay and Family Assistance form.

In cases of stillbirth and infant death, your maternity hospital or registered midwife will give you with the Bereavement Declaration. This will include a declaration for your attending doctor or midwife to complete.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please use self service, request someone to deal with us on your behalf, or contact us. We can help you access, complete and submit them.

Page last updated: 1 March 2024.
QC 20261