Application For Housing Benefit, Local Housing Allowance And Council Tax Reduction - Carmarthenshire County Council Page 8
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32Part 2
About Children - continued
First Child
Second Child
Third Child
Do you pay a registered
No
No
No
childminder, nursery, after
Yes
Yes
Yes
Tell us the
Tell us the
Tell us the
school club or any childminding
costs for this child?
name and registration
name and registration
name and registration
number of the minder
number of the minder
number of the minder
Name
Address
Registration no:
How much do you
How much do you
How much do you
pay a week?
pay a week?
pay a week?
£
£
£
We need to see
We need to see
We need to see
evidence
evidence
evidence
Your childcare provider needs to complete the HBD form to verify
the childcare charges you are paying.
Please note this form should only be completed if you/your
partner are employed for over 16 hours or more per week
Part 3
About other people who live with you
Do any adults usually live
No
with you and your partner?
By adults we mean people
Yes
over 16 who nobody gets
Give details below
Child Benefit for. e.g adult
Son, daughter, aunt, brother.
Does anyone usually live with
No
you but are currently serving as
Yes
a member of the Armed Forces?
Give details below
Now tell us about all the people who usually live with you and your partner. If you want to tell us
about more than 3 people, use a separate sheet of paper. If you are sending a separate sheet of
paper, tick this box.
Second person
Third person
First person
Last Name
Other names
Date of birth
8
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