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Form Ben Se - Financial Statement For Self-Employed People - Tunbridge Wells Borough Council Page 2

About this form

Please fill in this form if:

you or your partner are self-employed AND

„

you are not sending any business accounts with your claim form

„

We use partner to mean a person you are married to or a person you live with as if you are married to them.

Do not fill in this form if:

you or your partner only work for an employer and do no self-employed work

„

Tell us about the main self-employed work.

How to fill in this form

This form must be filled in by the self-employed person. Please answer all the questions on this form. Give as

much information as you can about any money you have received and any money you have paid out because of

your self-employed work. We need totals over a period of one year unless you have been self-employed for less

than one year.

About you

National Insurance (NI) number:

Surname or family name:

All other names:

Date of birth:

Home address and postcode: