editable pdf application forms
editable PDFs for you to complete on your screen
editable PDF application forms
These are some of our most used application forms and will help save you time when helping young people. If the application form you need isn’t here, you’ll need to carry on printing the standard version and complete it by hand. All other forms are on the Work and Income website.
$5k to work
Help to move to another area in New Zealand to start a new job, if the young person is on a benefit or qualifies for a benefit.
accommodation supplement
For young people who are already receiving a MSD benefits or payments, and wants to apply for help with accommodation costs.
appoint of an agent
An agent is someone who can act for the young person when dealing with a service of the Ministry of
Social Development or their Youth Service provider.
change of bank account
Young people can change their bank account number on MyMSD or by completing this form. Young people will need to provide proof of their new bank account details.
childcare assistance
Note: most YPP taiohi should complete the GCAP application form
Childcare subsidy (for pre-school childcare) or the OSCAR subsidy (for before or after school care).
Childcare Assistance application - S02 - JUL 2023
Childcare Assistance - Change of Circumstances - R24 - JUL 2023
child disability allowance
Payment if the young person is caring for a child with a serious health condition.
child inclusion
Tell us if a child has come into the care of a young person while they're getting a payment from us.
child support
If the young person is applying for a sole parent benefit, they must complete this form for them to apply for child support.
Civil Defence payments to Evacuees
To meet the immediate needs of people who are resident in an
area where a civil defence emergency has been declared and are required to leave their home.
Civil Defence Payments to Evacuees application - CD2W - FEB 2023
course participation assistance
Pay for costs the young person has because they're attending a short-term employment related course or programme.
disability allowance
If a young person has a disability, likely to continue for at least six months, they may be able to get extra help through a Disability Allowance.
emergency housing special needs grant
If young people have nowhere to stay tonight or in the next seven nights, and have no other adequate housing options, we may be able to help with the cost of emergency housing, such as a motel or hostel.
Emergency Housing Special Needs Grant form - SHA011W - DEC 2020
employment and earnings
To be completed by the young person's employer as verification of income, if we've asked the young person to do this as part of an application.
Employment and earnings - information for applications form - OCT 2021
extra help
If young people are finding it tough to meet everyday expenses and they don’t already get payments from MSD, they may be able to get extra help. This form contains applications for three types of assistance ASUP, DA and TAS.
extraordinary care fund
If the young person is receiving an Orphan's or Unsupported Child's Benefit for a child in their care, they can apply to the Extraordinary Care Fund for a grant of between $100 and $2,000 each financial year (1 July - 30 June).
funeral grant
A Funeral Grant may help with some of the funeral costs for a person who has died.
guaranteed childcare assistance payment
Apply for help with the cost of childcare for children under 5, while the young parent is in education, training or work-based learning.
Please note: editable PDF unavailable at this time. This is a print version.
Guaranteed Childcare Assistance Payment application - SEP 2023
including a partner
If a partner of a Youth Service taiohi is getting a benefit from Work and Income, the young partner will need to be included in their benefit and may receive payments as well.
jobseeker support obligations
Jobseeker Support is about helping clients into full-time work and supporting you with a weekly payment while they’re not working.
Note: an editable form is not yet available. This is a print form.
limited service volunteer
Young people to complete this form if they want to apply to go on the Limited Service Volunteer (LSV) programme.
orphan’s/unsupported child’s benefit
If a young person is raising someone else’s child, we may be able to help by meeting some of the costs involved.
Orphan’s Benefit is for people looking after someone else’s child because their parents have died or can’t be found, or when they can’t look after their child because the parent has a long-term illness.
Unsupported Child’s Benefit is for people looking after someone else’s child because the child’s parents can’t support them due to a family breakdown.
Orphan’s/Unsupported Child’s Benefit application form - M14 - JUL 2021
parent’s income verification form
YPP clients still living at home need their parents or caregivers to complete the parent’s income verification form.
Please note: editable PDF unavailable at this time. This is a print version.
redirection of benefit payment
A redirection of benefit payment is where part or all of your benefit is paid to another person or organisation by the Ministry of Social Development.
retailer/supplier/payee details
A retailer, supplier or payee expecting to receive money from the Ministry of Social Development that relates to a client, will need to complete this form.
Work and Income Supplier Registration online Form
Retailer/Supplier/Payee Details form - ISS22W - SEP 2023 (print verion)
review of decision
If MSD has made a decision the young person doesn't agree with, they can use this form to ask for a formal Review of Decision.
sole parent support obligations
Sole Parent Support is a weekly payment that helps single parents find part-time work or get ready for further work.
Please note: editable PDF unavailable at this time. This is a print version.
temporary additional support
Temporary Additional Support helps with essential costs for a short time when then young person has tried everything they an think of, and still cannot pay for them.
Temporary Additional Support application form - S26 - AUG 2023
tenancy costs cover
This Confirmation of application and acceptance of terms of the Tenancy Costs Cover sets out the
conditions of the grant.
training incentive allowance
Training Incentive Allowance is extra money to help pay for costs while young parents are studying. It can help with things like fees, books, equipment, travel, childcare and care of other people.
transition to work grant
Apply for help with the cost of looking for, or moving into, work.
Transition to Work Grant applicant form - LAB995W - JUL 2023
transitional housing consent form
Consent to share some information we hold about you with transitional housing providers and Te Tūāpapa Kura Kāinga – Ministry of Housing and Urban Development.
Please note: editable PDF unavailable at this time. This is a print version.
young parent payment
Young Parent Payment is for young parents aged 16 to 19 who have dependent children, and are in need of financial assistance.
Young Parent Payment application - YS011W - AUG 2023
Young Parent Payment obligations - YS011W - JUL 2023*
Young Parent Payment partner application - YS012W - JUL 2023
Young Parent Payment partner obligations - YS012W - JUL 2023*
*Please note: editable PDF unavailable at this time. This is a print version.
youth payment
Youth Payment is for young people aged 16 or 17 who don’t have dependent children, and are in need of financial assistance.
Youth Payment application - YS009W - JUL 2023
Youth Payment obligations - YS009W - JUL 2023*
Youth Payment partner application - YS010W - JUL 2023
Youth Payment partner obligations - YS010W - JUL 2023*
Please note: editable PDF unavailable at this time. This is a print version.
youth service continue or stop payments form
This form should be used when:
- Youth Service clients with no children are turning 18, or
- Youth Service clients with children are turning 20.
Youth Service Continue or stop payments form YS014W - DEC 2019
youth payment and young parent payment information handover
This form collects information you hold on the young person that will help their Work and Income case manager and enable the young person to continue on their journey to independence.
Youth Payment and Young Parent Payment information handover form - YS018W - NOV 2014
youth service payment card balance transfer
Young people to apply for a balance transfer if they want to use your Youth Service Payment Card to buy from somewhere that doesn't accept the Youth Service payment card.
Please note: editable PDF unavailable at this time. This is a print version.
Youth Service payment card balance transfer application - YS019W - JAN 2015