Income Permission Form - Student Finance England - 2017/18 Page 2
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Your dependants - continued
2.2
Child dependants in further or higher education in academic year 2017/18
Do not include the student when completing this question.
If the student is your partner, please include any children they named in their application for
Student Finance if the children have applied for student finance.
Are they receiving
financial support?
If so, from which
School, college or
authority or
university
organisation?
Full name
Date of birth
Course
(DD MM YYYY)
Declaration
Our Data Protection Statement sets out who will use the information provided on this form and what they
will use it for. Before signing this form please read our statement online at
If you don’t give your permission to re-use your data for 2017/18 applications, and you don’t
!
qualify for another current year income assessment, we can’t use any other financial information
from you. This means the student(s) won’t receive their full student finance entitlement.
Your decision about bursary and scholarship data sharing consent will not affect the student’s entitlement to
any other financial support available.
In order for a university or college to determine and pay any bursary or scholarship to which the student(s)
you are supporting may be entitled, we will share some of your personal and financial details with them.
If you do not wish your details to be shared for this purpose, please tick this box.
Your Customer Reference Number
Your Name
(in BLOCK CAPITALS)
Your Signature
MONTH
YEAR
DAY
-
-
Today’s date
Once you have completed this form and signed and dated the declaration, return it to:
Student Finance England, PO Box 210, Darlington, DL1 9HJ
SFE/IPF/1718
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