Government of Western Australia
C1
Application for Concession
Department of Transport
Driver and Vehicle Services
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If your concession entitlement is reduced or withdrawn, you must notify the Department of Transport immediately.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 INFORMATION
CONCESSION APPLICATION TYPE
VEHICLE LICENCE
VEHICLE LICENCE CONCESSION
The appropriate pension concession card and/or letter from the pension
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
application for a motor vehicle licence concession.
Concession can only be applied to one vehicle at one time.
DRIVER’S LICENCE
APPLICANT DETAILS
FAMILY NAME
THE MOTOR VEHICLE LICENCE CONCESSION APPLIES TO ONLY
ONE OF THE FOLLOWING:
FIRST NAME
1.
2.
3.
4.
5.
OTHER NAME/S
100% Concession
DATE OF BIRTH
/
To be eligible for a 100% vehicle licence fee concession (exemption) and
exemption from vehicle licence duty you must hold one of the following:
/
•
PHONE NUMBER
EMAIL ADDRESS
RESIDENTIAL ADDRESS
W A
POST CODE
CONCESSION DETAILS
50% Concession
PENSIONER CONCESSION CARD
Card number
Date of grant
To be eligible for a 50% vehicle licence fee concession you must hold one
of the following:
•
Centrelink Pensioner Concession Card;
•
Veterans’ Affairs Pensioner Concession Card; or
•
WA Seniors Card and Commonwealth Seniors Health Card (both
cards must be presented).
Expiry date
VETERANS CONCESSION CARD
Card number
Date of grant
DRIVER’S LICENCE CONCESSION
Expiry date
100% Concession
To be eligible for a 100% concession on your driver’s licence you must
present one of the following cards:
COMMONWEALTH SENIORS HEALTH CARD
Card number
Date of grant
•
•
Expiry date
•
WA SENIORS CARD (Driver’s licence only)
Card number
Date of grant
•
Expiry date
pension.
/
To be eligible for a 50% concession on your driver’s licence you must
present one of the following cards:
•
•
•
Any other Centrelink Pensioner Concession Card;
WA Seniors Card; or
Veterans’ Affairs Pensioner Concession Card (where the holder is
receiving a service pension and has not yet reached pension age).
Please contact the Department of Veterans’ Affairs for more information.
Photo Card Concession
SIGNATURE OF APPLICANT
DATE
Centrelink Aged Pensioner Concession Card;
WA Seniors Card and Commonwealth Seniors Health Card (both cards
must be presented);
Veterans’ Affairs Pensioner Concession Card (where the holder is
receiving a service pension and is of pension age. Please contact the
Department of Veterans’ Affairs for more information); or
Veterans’ Affairs Gold Repatriation Health Card - endorsed TPI or EDA.
50% Concession
I declare that the information on this form is true and correct.
I understand that under the Road Traffic (Administration) Act 2008, it is
an offence to provide false or misleading information. I consent to checks
being carried out to confirm my ongoing entitlement to concessions, and
will report any changes to my eligibility.
I declare that I am in receipt of the
Letter from Veterans’ Affairs or Centrelink stating you are receiving the
maximum rate of pension and one of the following:
• Veterans’ Affairs Service Invalid Pension Card; or
• Centrelink Pension Card (blind); or
• Centrelink Disability Support Pension Card; or
• Centrelink Pension Card (carer).
Or one of the following:
•
Letter from Veterans’ Affairs certifying the applicant has been
assessed at 60 or more impairment points.
•
Veterans’ Affairs Pension Card endorsed TPI (no letter from pension
provider required).
•
Veterans’ Affairs Pension Card endorsed EDA (no letter from pension
provider required).
SUBURB
STATE
a car or bus with an unloaded mass not exceeding 3000 kg;
a goods vehicle with an unloaded mass not exceeding 3000 kg;
a motor home;
a motor cycle; or
a moped as defined in the Road Traffic (Authorisation to Drive)
Regulations 2008.
The concession on your driver’s licence will be applied to your future photo card
applications.
/
Last updated:26.07.2017
GENERAL 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 www.transport.wa.gov.au/dvs 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:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
Academic (Post-Secondary Institution)
Accountant
Architect
Australian Consular Officer
Australian Diplomatic Officer
Bailiff
Bank Manager
Chartered Secretary
Chemist
Chiropractor
Company Auditor or Liquidator
Court Officer
Defence Force Officer
Dentist
Doctor
Engineer
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
Commonwealth Industrial Organisation Secretary
Insurance Broker
Justice of the Peace
Lawyer
Local Government CEO or Deputy CEO
Local Government Councillor
Loss Adjuster
Marriage Celebrant
Member of Parliament
Minister of Religion
Nurse
Optometrist
Patent Attorney
Physiotherapist
Podiatrist
Police Officer
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
Post Office Manager
Psychologist
Public Notary
Public Servant (State or Commonwealth)
Real Estate Agent
Settlement Agent
Sheriff or Deputy Sheriff
Surveyor
Teacher
Tribunal Officer
Veterinary Surgeon
Any other authorised person under the
Statutory Declarations Act 1959 of the
Commonwealth
OFFICE USE ONLY
Vehicle licence concession checklist
Driver’s licence concession checklist
Social 100% concessions Code 411
Social 100% concessions
Letter from Veterans’ Affairs or Centrelink stating the
Age Pension Concession Code (A)
applicant is receiving the maximum rate of pension and
Veteran Age Pension Concession Code (V)
one of the following:
WA Seniors Card and Commonwealth Seniors Health Card
Veterans’ Affairs Service Invalid Pension Card
Centrelink Pension Card (Blind)
(both cards must be sighted)
Centrelink Disability Support Pension Card (Spouse)
Photocopy of card(s) attached
Centrelink Disability Support Pension Card
Centrelink Pension Card (Carer)
Social 50% concessions
Photocopy of card(s) attached
Pensioner concession (P)
Or one of the following:
Veteran Pension concession Type (V)
Letter from Veterans’ Affairs certifying the applicant has
been assessed at 60 or more impairment points
WA Seniors Card sighted
Veterans’ Affairs Pension Card endorsed TPI (no letter
from pension provider required)
Concession details entered on record
Veterans’ Affairs Pension Card endorsed EDA (no letter
from pension provider required)
Photocopy of card(s) attached
Photocopy of cards/documents attached
Social 50% concessions Code 412
Centrelink Pension Concession Card
Veterans’ Affairs Pensioner Concession Card
WA Seniors Card and Commonwealth Seniors Health
Card (both cards must be sighted)
Photocopy of card(s) attached
OPERATOR NAME
SITE
SIGNATURE
DATE