✨ Maternity Claim Form




1168 NEW ZEALAND GAZETTE No. 40


LESS TOTAL DISBURSEMENTS
(GST inclusive) $\square\square\square\square\square\square

AMOUNT PAYABLE
(GST inclusive) $\square\square\square\square\square\square


CERTIFICATION

I certify I have provided the above services in accordance with the service specifications in the Section 88 Notice and that the above information is correct.


Name of Lead Maternity Carer (Please print in capital letters)

____________________________________________________

Signature of Lead Maternity Carer

____________________________________________________

Date

___________



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Online Sources for this page:

VUW Te Waharoa PDF NZ Gazette 2002, No 40


Gazette.govt.nz PDF NZ Gazette 2002, No 40





✨ LLM interpretation of page content

πŸ₯ Claim Form for Second Trimester, Third Trimester, and Labour and Birth (continued from previous page)

πŸ₯ Health & Social Welfare
Maternity, Claim Form, Second Trimester, Third Trimester, Labour and Birth, Health Benefits