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This form is used to request a statement of Recoverable Benefits.

Please see Recovery of Benefits and Assistance (RBA) Scheme for further information.

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Application Form: Recovery of Benefits and Assistance (RBA) Scheme (RBA01)

Recovery of Benefits & Assistance (RBA) Scheme Application Form (RBA01) June 2024

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Recovery of Benefits and Assistance RBA01 (word document version)

Edition: June 2024

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