Funeral Assistance Payment Request

Funeral Assistance Payment Request

Application Form
Acknowledgement of Sorry Business

NNAC recognises the deep cultural significance and emotional hardship of sorry business within our community. We extend our heartfelt condolences to you and your family during this time of loss.

This form has been developed to support Narungga Nation members who are experiencing financial hardship related to the passing of a loved one.

Please complete this form to request assistance. All applications will be treated with respect, care, and confidentiality.
Dear Member,

Please note that once a Request for Funeral Assistance Form has been submitted and approved, please allow up to 4 business days for processing.

We understand the importance of timely support during times of sorry business, and our team is committed to processing requests as efficiently as possible.

We recommend submitting all required documentation as early as you can to help avoid any delays. Thank you for your understanding.

If you have any further questions, please email hello@nnac.org.au.
I am applying for a funeral assistance payment for the passing of:
First Name:*
Last Name:*
Who passed away on:*

DayMonthYear
Date
What is your relationship to the person who has passed?*
The funeral assistance payment will be contributing to the cost of: *
Applicant Information
First Name:*
Last Name:*
Primary Contact Phone Number*
Secondary Contact Phone Number
Address*

Street Address

Street Address Line 2

CityState

Postcode
Bank Details for Transfer

Please provide the bank account details for the Funeral Assistance Payment (if approved).
Name of Bank*
Bank Account Name*
BSB*
Account Number*
Signature*

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Date*

DayMonthYear
Need Someone to Yarn To?

If you’re feeling overwhelmed or need someone to talk to during sorry business, 13YARN offers support. It’s the first national crisis support line created specifically for Aboriginal and Torres Strait Islander people.

You can have a confidential, one-on-one yarn with a trained Aboriginal or Torres Strait Islander crisis supporter who understands our ways and our grief. This free service is available 24 hours a day, 7 days a week. It’s a safe and culturally appropriate space where you can talk without judgment.

Call 13 92 76 or visit 13yarn.org.au for more information.
Privacy Statement

We collect your personal information to manage your membership, keep you informed, and provide relevant services and updates. Your information is stored securely and will only be accessed by authorised staff. We will never share your details with third parties without your consent, unless required by law.

By submitting this form, you agree to the collection and use of your personal information in accordance with this privacy statement.
Should be Empty:

Funeral Assistance Payment Request

I am applying for a funeral assistance payment for the passing of:

Applicant Information

Bank Details for Transfer