A Claim Form For Housing Benefit And Council Tax Support Page 22
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28About children (continued from page 4)
page 22
Please use this page if you
Fourth child
Fifth child
Sixth child
have more than three children
Last name
Other names
Date of birth
/
/
/
/
/
/
What is the child’s sex?
The child’s relationship to
you
The child’s relationship to
your partner
Usual address, if different
from yours
Child Benefit number
Who gets the Child Benefit
for them?
We need to see proof of this.
Does the child have any
No
No
No
savings?
Yes
How much are their
Yes
How much are their
Yes
How much are their
savings?
savings?
savings?
£
£
£
We need to see proof of this.
We need to see proof of this.
We need to see proof of this.
Is the child disabled?
No
No
No
Yes
Yes
Yes
Does that disability make it
No
No
No
difficult for the child to
Yes
We may write to you
Yes
We may write to you
Yes
We may write to you
share a bedroom with other
for more information
for more information
for more information
children?
about this.
about this.
about this.
Is the child registered
No
No
No
blind?
Yes
We need to see proof
Yes
We need to see proof
Yes
We need to see proof
of this.
of this.
of this.
Does the child get Disability
No
No
No
Living Allowance?
Yes
How much?
Yes
How much?
Yes
How much?
Care
£
£
£
Mobility
£
£
£
Do you or your partner pay
No
No
No
any childminding costs for
Yes
Please tell us about it
Yes
Please tell us about it
Yes
Please tell us about it
this child to a registered
below.
below.
below.
childminder, a nursery or
an after-school club?
Tell us the name and
registration number of the
minder.
How much do you pay a
£
a week
£
a week
£
a week
week?
We need to see proof of this.
We need to see proof of this.
We need to see proof of this.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business