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Zorgtoeslag (Healthcare Allowance) Application

Tell us about you

    Which year would you like to apply for?

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    Marital Status*

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Tell us about your stay in the Netherlands

    Do you have Dutch health insurance? *

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    Are you in military service?*

    Are you in the Netherlands to study?*

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    Did you register with the local authorities?

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    Did you de-register with the local authorities?

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What kind of income did you receive from the Netherlands? Please state the total amount in Euro for each

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* Please send us copies of all relevant records you kept for this income

    Did you receive any other income from sources outside the Netherlands?

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    Do you have any savings or investments over 116613 Euro?

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* The value of your home should NOT be included

Spouse / Partner

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Tell us about your Spouse / Partner stay in the Netherlands

    Does your spouse/partner have Dutch health insurance?*

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  • calendar valid

    Is your spouse/partner in military service?*

    Is your spouse/partner in the Netherlands to study?*

  • calendar valid
  • calendar valid
  • calendar valid
  • calendar valid

    Did your spouse/partner register with the local authorities?

  • calendar valid

    Did your spouse/partner de-register with the local authorities?

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What kind of income did your spouse/partner receive from the Netherlands? Please state the total amount in Euro for each

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  • valid
  • valid
  • valid
  • valid
  • valid
  • valid
  • valid

    Upload records in the fields below

  • Browse...

    Upload records in the fields below

  • Browse...

    Upload records in the fields below

  • Browse...

* Please send us copies of all relevant records you kept for this income

    Did your spouse/partner receive any other income from sources outside the Netherlands?*

  • valid
  • valid
  • valid

    Does your partner/spouse have any savings or investments?

  • valid
  • valid
  • valid

* The value of your home should NOT be included

  • valid