Housing Benefit Clam Form And Council Tax Reduction Page 26

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Page 26
Part 13 About benefits and pensions
Are you or your partner
getting any benefits or waiting
No
Go to Part 14 on page 28
to hear about any benefits you
Tell us the full rate of the benefits before any
?
Yes
have claimed
deductions.
Tell us about any benefits you or your partner are getting now or have
claimed and are waiting to hear about. Examples of benefits include:
- Bereavement Allowance
- Pension Credit
- Carer’s Allowance
- Retirement Pension
- Child Benefit
- Adoption Pay
- Child Tax Credit
- Severe Disablement Allowance
- Contribution- based Jobseeker’s Allowance
- Statutory Sick Pay
- Employment and Support Allowance
- Statutory Maternity Pay
- Fostering Allowance
- Statutory Paternity Pay
- Guardian’s Allowance
- War Disablement Benefit
- Incapacity Benefit
- War Pension
- Industrial Injuries Disablement Benefit
- War Widow’s Pension
- Industrial Death Benefit
- Widow’s or Widower’s Benefits
- Contribution- based Jobseeker’s Allowance
- Working Tax Credit
- Maternity Allowance
If you or your partner are getting a pension from a
former employer or from a private pension scheme,
please tell us about it in Part 15 on page 30
If there is not enough room on this form for all the
benefits you and your partner are getting or have
claimed, please use a separate sheet of paper to tell
us about the others.
If you are sending a separate sheet of paper, tick this
box.
You
Your partner
Do you or your partner get
No
No
Contribution-based
Employment and Support
Yes
Yes
Allowance?
£
£
every
How much and how often?
every
Does it include:
- a support component?
- a work-related component?
(Please tick)
Are you still waiting for a
No
No
Work Capability
You need to tell us
You need to tell us
Assessment?
Yes
Yes
when you receive
when you receive
a decision about
a decision about
your assessment
your assessment

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