Housing Benefit And Council Tax Support Claim Form Page 6
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18Part D
Questions about work
1.
Do you or your partner do any work, regardless of the hours
Yes
No
worked or whether you are paid?
If ‘Yes’, please answer all the questions in this part. If ‘No’, go to Part E.
2.
Are you or your partner self-employed?
Yes
No
If ‘Yes’, please fill in a Self-employed Income form (you can download this form from our website).
You
Your Partner
3.
What is the name of
your employer?
4.
When did you start this job?
/
/
/
/
5.
How many hours do you
work on average each week?
!
6.
How much do you get paid?
7.
How often?
8.
How are you paid, for example
cash, cheque or BACS?
9.
If you expect your earnings
to change please tell us
when and why
!
10.
If your job is due to end
/
/
/
/
soon please tell us the date
11.
Do you pay into a private
pension scheme?
Yes
No
Yes
No
12.
Are you getting Statutory
Sick Pay, Maternity Pay,
Yes
No
Yes
No
Paternity Pay or Adoption
Pay from your employer at
the moment?
If ‘Yes’, when do you
/
/
/
/
expect to return to work?
13.
Do you have any other jobs?
Yes
No
Yes
No
If ‘Yes’, please give full details in Part K.
You must tell us straight away if your earnings change, this includes any periods of overtime or if
you earn more or less than usual.
If you have recently started work and do not have any payslips, please ask your employer to fill in a
Certificate Of Earnings form (you can download this form from our website).
Page 6
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