Housing Benefit Clam Form And Council Tax Reduction Page 7

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Page 7
Part 2
About children - continued
Second child
Third child
First child
Is the child registered
No
No
No
blind?
Yes
Yes
Yes
Important! We need to see evidence that the child is registered blind
Does the child get Disability
No
No
Living Allowance?
Yes
Yes
How much?
How much?
Higher rate: £
Higher rate: £
Care component
Middle rate: £
Middle rate: £
Lower rate: £
Lower rate: £
Mobility component
Mobility:
£
Mobility: £
Do you pay a
registered
childminder, nursery,
No
No
No
or after-school club
any childminding
Tell us about
Tell us about
Tell us about
Yes
Yes
Yes
costs for this child?
this below
this below
this below
Tell us the name and
registration number
of the minder
How much do you
£
£
£
pay a week?
Does the child go to
No
No
No
school or college?
Tell us about
Tell us about
Tell us about
Yes
Yes
Yes
this below
this below
this below
Name and address
of school or
college
If the child has ever
changed school or
college, please give
the name and
address of the
previous school or
college
Important! We need to see evidence of the childminding costs

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