Benefit Application Form (BA1)

Online claims are processed faster

Top tip: Use your phone or tablet to fill in the BA1 form, then upload your receipts as photos

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Call our team on 0800 653 473. If your call is not answered, please leave a message. We will get back to you promptly.

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Contact NZFFWS

Phone: 0800 65 34 73
Email: office@firefighters.org.nz

It can be easiest to fill this form out on a mobile phone or tablet. This makes it easy to take photos of your receipts, then attach them to the form.

PLEASE REMEMBER ALL CLAIMS MUST HAVE RECEIPTS ATTACHED.

If you are using a computer, you will need to transfer copies/images of your receipts to your computer, then add them to the form when you fill it out.

"*" indicates required fields

First Names*

Last Name*

Membership Number*

Email Address*

Benefit Claimed*

Amount Claimed*

Please upload copies/photos of receipts here - receipts must accompany claim.*

Drop files here or

Accepted file types: jpg, gif, png, pdf, heic, heif, Max. file size: 100 MB.

Claim Details*

Bank Account number for reimbursement payment*

Date of Application*

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