4.2 Funeral Travel Form

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4.2 Funeral Travel Form

Program 4: Cultural Support

4.2 Funeral Travel Form

This program provides up to $1,200 per financial year for IBN members to attend funerals.

Applicant details

Name(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Gender

Male

Female

Language Group(Required)

Yinhawangka

Banyjima

Nyiyaparli

Non-IBN legal carer

Current home address(Required)

Postcode

Phone(Required)

Email address

Have your personal details changed?(Required)

No

Yes (If yes, please complete an ‘Update personal details’ form and attach it to your application.)

Drop files here or

Max. file size: 10 MB.

Date of funeral(Required)

Location of funeral(Required)

Name of deceased person(Required)

Items for purchase (NO CASH PAYMENTS)

For details on what expenses IBN will cover, please see the IBN 2021-22 Community Programs
Handbook, or the IBN website: www.ibngroup.com.au

List(Required)

Description of item (what is the money for?)

Name of supplier (who is being paid?)

Amount

Comments

Food and fuel up to $350 per application – please tick your preferred payment method(Required)

Food voucher

Food card

Fuel voucher

Fuel card

Required Documents

Funeral notice
Supplier quotes or invoices including payment details

Upload Documents

Drop files here or

Max. file size: 10 MB.

Declaration

I declare that the information in this form is true and correct, and the benefits requested are for my own use.

Agreement

I agree that IBN:

may share my information with other organisations for application assessment purposes.

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CONTACT IBN

FREECALL: 1800 014 401 admin@ibngroup.com.au www.ibngroup.com.au

IBN Group acknowledges the the Yinhawangka, Banyjima and Nyiyaparli people as the traditional people in and around the Hamersley Ranges and custodians of the land.

Aboriginal and Torres Strait Islander peoples should be aware that this website and associated links may contain images, voices or names of people who have passed away.

IBN Group respects the community’s cultural protocols, and we acknowledge that images of IBN members, IBN children and IBN staff are featured throughout the website. If any image featured on our website needs to be removed for cultural purposes, please contact our Communications Officer on 9140 0900 or communications@ibngroup.com.au

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