Form Cb 1 - Application Form For Child Benefit Page 7
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16Part 2 continued
Habitual Residence condition
24.Does any of your or your spouse’s, civil partner’s or cohabitant’s close family, for example,
parent, brother or sister, live in the Republic of Ireland?
Yes
No
If ‘Yes’, please state:
Person 1
Their surname:
Their first name(s):
Their date of birth:
D D
M M
Y Y Y Y
Their address:
Their relationship to you:
Date they came to the
Republic of Ireland:
D D
M M
Y Y Y Y
Person 2
Their surname:
Their first name(s):
Their date of birth:
D D
M M
Y Y Y Y
Their address:
Their relationship to you:
Date they came to the
Republic of Ireland:
D D
M M
Y Y Y Y
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