Housing Benefit Council Tax form March2013, Prywatne, Pobrane
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//-->Cardiff County CouncilA claim form for Housing Benefit/Council Tax Benefit/Council Tax ReductionAre you(please tick one box):a council tenant?Kan owner-occupier?Ka private tenant?Ka housing association or social landlord tenant?Did you claim at your last address?NoYesa hostel resident?Part 1Bypartnerwe mean• a person you are married to or a personyou live with as if you are married tothem, or• a civil partner or a person you live withas if you are civil partnersAbout you and your partnerNoYesIf you have a partner,you must answer allthe questions aboutthem.Do you have a partner whonormally lives with you?For official useDate issuedReceipt StampYouYour partnerLast nameOther namesTitle(Mr, Mrs, Ms and so on)AddressThis is the address that you want toclaim benefit for.Do not tell us your partner’saddress if it is the same as yours.Postcode:Postcode:Date of birthNational Insurance numberYou can find this on payslips orletters from social security or thetax office. We cannot decide yourclaim if we do not have yourNational Insurance number.Letters////NumbersLetterLettersNumbersLetterTell us any other names youhave used.Your phone numberYou do not have to tell us this, butit may help us deal with your claimmore quickly.What date did you move to thisaddress?If you have moved home in thelast 12 months, tell us your lastaddress and the date you left theproperty.////Postcode:Postcode:/Have you or your partner come tolive in England, Northern Ireland,Scotland, Wales, the Republic ofIreland, the Channel Islands or theIsle of Man in the last 5 years?NoYes/NoWe will write to you about this.//YesWe will write to you about this.1Part 1If your nationality is not British,on what date did you last arrivein the UK?What is your nationality?The UK is England, NorthernIreland, Scotland and Wales.About you and your partner -continuedYou//Your partner//NationalityNationalityHave you or your partnerclaimed Housing Benefit/Council Tax Benefit/Council TaxReduction within the last 5years?NoYesWhen did you claim?NoYesWhen did you claim?////What address did you claim for?What address did you claim for?Postcode:Postcode:Are you or your partner inhospital at the moment?NoYesWhen did you go in?NoYesWhen did you go in?//Does anyone get Carer’sAllowance for looking after youor your partner?Please tick‘Yes’if you or yourpartner have been told you areentitled to Carer’s Allowance eventhough you do not get it, becauseyou are getting another benefitinstead.//NoYesPlease give their name and address.////When do you expect to come out?When do you expect to come out?NoYesPlease give their name and address.Please tick if you or your partnerare:• a student• a former resident of ahomeless hostel• an apprentice• on youth training• in legal custody• severely mentally impaired• registered blind• long-term sick or disabledand incapable of workPostcode:Postcode:We will contact you if we need any more information.2Part 2About childrenWe need to know about any children in your household who are:• under 16;• aged 16 or 17 and registered for work or youth training; or• aged 16 or over, but still under 20 and in education doing a course not higherthan GCE A level, SCE Higher level or GNVQ (advanced).Are there any children in yourhousehold as described?NoYesGo to Part 3.Tell us about the children you want to claim for. If you want toclaim for more than 3 children, use a separate sheet of paper.If you are sending a separate sheet of paper, tick this box.First childLast nameOther namesDate of birthWhat is the child’s sex?The child’s relationship to youChild Benefit numberWho gets the Child Benefit forthem?We need to see proof of this.Second childThird child//////Is the child registered blindor getting Disability LivingAllowance?NoYesNoYesNoYesDo you pay any childmindingcosts for this child?For example, to a childminder,nursery or after-school club.NoYesTell us the name andregistration numberof the minder.NoYesTell us the name andregistration numberof the minder.NoYesTell us the name andregistration numberof the minder.How much do you pay a week?How much do you pay a week?How much do you pay a week?£We need to see proof.£We need to see proof.£We need to see proof.Read the Checklist at Part 17 to see what you can use as proof.3Part 3Do any adults normally livewith you and your partner?Byadultswe mean peopleover 16 who nobody getsChild Benefit for.About other people who live with youNoYesGo to Part 4.Tell us about all the adults, except your partner, whousually live with you. If you want to tell us about more than 3people, use a separate piece of paper.If you are sending a separate sheet of paper, tick this box.Are any of the people whonormally live with you marriedto each other or living togetheras if they were married?NoYesTell us their names.is the partner ofAndis the partner ofNow tell us about all the peoplewho normally live with you andyour partner.First personLast nameOther namesDate of birthTheir relationship to youFor example, aunt, brother,daughter, father, grandson,grandmother, stepdaughter,joint tenant, joint owneror friend.Second personThird person//////National Insurance NumberWe can make a decision on yourclaim quicker, if you give us thisinformation.LettersNumbersLetterLettersNumbersLetterLettersNumbersLetterDo they get Income Support,income-based Jobseeker’sAllowance, Pension Credit orEmployment Support Allowance(Income Related)?Do they get Disability LivingAllowance or AttendanceAllowance, or are theyregistered blind?Are they a full-time student, astudent nurse, a care worker, anapprentice or on youth training?NoYesNoYesNoYesNoYesNoYesNoYesNoYesNoYesNoYesDo they pay rent to youor your partner?NoYesNoYesNoYes4Part 3Are they severelymentally impaired?About other people who live with you -continuedNoYesNoYesNoYesAre they in legal custodyat the moment?NoYes/When are theyexpected to comeout?NoYes/When are theyexpected to comeout?NoYes/When are theyexpected to comeout?///Are they in hospitalat the moment?NoYes/When did theygo in?NoYes/When did theygo in?NoYes/When did theygo in?///When are they expected tocome out?When are they expected tocome out?When are they expected tocome out?//////Do they normally work for16 hours or more a week?NoYesTell us theirearnings beforedeductions forthings like tax andNational Insurance.NoYesTell us theirearnings beforedeductions forthings like tax andNational Insurance.NoYesTell us theirearnings beforedeductions forthings like tax andNational Insurance.£££We need to see proofof their earnings.We need to see proofof their earnings.We need to see proofof their earnings.Do they have any otherincome at all?NoYesTell us their otherincome beforedeductions forthings like tax andNational Insurance.NoYesTell us their otherincome beforedeductions forthings like tax andNational Insurance.NoYesTell us their otherincome beforedeductions forthings like tax andNational Insurance.£££We need to see proofof their income.We need to see proofof their income.We need to see proofof their income.Read the Checklist at Part 17 to see what you can use as proof.5 [ Pobierz całość w formacie PDF ]
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//-->Cardiff County CouncilA claim form for Housing Benefit/Council Tax Benefit/Council Tax ReductionAre you(please tick one box):a council tenant?Kan owner-occupier?Ka private tenant?Ka housing association or social landlord tenant?Did you claim at your last address?NoYesa hostel resident?Part 1Bypartnerwe mean• a person you are married to or a personyou live with as if you are married tothem, or• a civil partner or a person you live withas if you are civil partnersAbout you and your partnerNoYesIf you have a partner,you must answer allthe questions aboutthem.Do you have a partner whonormally lives with you?For official useDate issuedReceipt StampYouYour partnerLast nameOther namesTitle(Mr, Mrs, Ms and so on)AddressThis is the address that you want toclaim benefit for.Do not tell us your partner’saddress if it is the same as yours.Postcode:Postcode:Date of birthNational Insurance numberYou can find this on payslips orletters from social security or thetax office. We cannot decide yourclaim if we do not have yourNational Insurance number.Letters////NumbersLetterLettersNumbersLetterTell us any other names youhave used.Your phone numberYou do not have to tell us this, butit may help us deal with your claimmore quickly.What date did you move to thisaddress?If you have moved home in thelast 12 months, tell us your lastaddress and the date you left theproperty.////Postcode:Postcode:/Have you or your partner come tolive in England, Northern Ireland,Scotland, Wales, the Republic ofIreland, the Channel Islands or theIsle of Man in the last 5 years?NoYes/NoWe will write to you about this.//YesWe will write to you about this.1Part 1If your nationality is not British,on what date did you last arrivein the UK?What is your nationality?The UK is England, NorthernIreland, Scotland and Wales.About you and your partner -continuedYou//Your partner//NationalityNationalityHave you or your partnerclaimed Housing Benefit/Council Tax Benefit/Council TaxReduction within the last 5years?NoYesWhen did you claim?NoYesWhen did you claim?////What address did you claim for?What address did you claim for?Postcode:Postcode:Are you or your partner inhospital at the moment?NoYesWhen did you go in?NoYesWhen did you go in?//Does anyone get Carer’sAllowance for looking after youor your partner?Please tick‘Yes’if you or yourpartner have been told you areentitled to Carer’s Allowance eventhough you do not get it, becauseyou are getting another benefitinstead.//NoYesPlease give their name and address.////When do you expect to come out?When do you expect to come out?NoYesPlease give their name and address.Please tick if you or your partnerare:• a student• a former resident of ahomeless hostel• an apprentice• on youth training• in legal custody• severely mentally impaired• registered blind• long-term sick or disabledand incapable of workPostcode:Postcode:We will contact you if we need any more information.2Part 2About childrenWe need to know about any children in your household who are:• under 16;• aged 16 or 17 and registered for work or youth training; or• aged 16 or over, but still under 20 and in education doing a course not higherthan GCE A level, SCE Higher level or GNVQ (advanced).Are there any children in yourhousehold as described?NoYesGo to Part 3.Tell us about the children you want to claim for. If you want toclaim for more than 3 children, use a separate sheet of paper.If you are sending a separate sheet of paper, tick this box.First childLast nameOther namesDate of birthWhat is the child’s sex?The child’s relationship to youChild Benefit numberWho gets the Child Benefit forthem?We need to see proof of this.Second childThird child//////Is the child registered blindor getting Disability LivingAllowance?NoYesNoYesNoYesDo you pay any childmindingcosts for this child?For example, to a childminder,nursery or after-school club.NoYesTell us the name andregistration numberof the minder.NoYesTell us the name andregistration numberof the minder.NoYesTell us the name andregistration numberof the minder.How much do you pay a week?How much do you pay a week?How much do you pay a week?£We need to see proof.£We need to see proof.£We need to see proof.Read the Checklist at Part 17 to see what you can use as proof.3Part 3Do any adults normally livewith you and your partner?Byadultswe mean peopleover 16 who nobody getsChild Benefit for.About other people who live with youNoYesGo to Part 4.Tell us about all the adults, except your partner, whousually live with you. If you want to tell us about more than 3people, use a separate piece of paper.If you are sending a separate sheet of paper, tick this box.Are any of the people whonormally live with you marriedto each other or living togetheras if they were married?NoYesTell us their names.is the partner ofAndis the partner ofNow tell us about all the peoplewho normally live with you andyour partner.First personLast nameOther namesDate of birthTheir relationship to youFor example, aunt, brother,daughter, father, grandson,grandmother, stepdaughter,joint tenant, joint owneror friend.Second personThird person//////National Insurance NumberWe can make a decision on yourclaim quicker, if you give us thisinformation.LettersNumbersLetterLettersNumbersLetterLettersNumbersLetterDo they get Income Support,income-based Jobseeker’sAllowance, Pension Credit orEmployment Support Allowance(Income Related)?Do they get Disability LivingAllowance or AttendanceAllowance, or are theyregistered blind?Are they a full-time student, astudent nurse, a care worker, anapprentice or on youth training?NoYesNoYesNoYesNoYesNoYesNoYesNoYesNoYesNoYesDo they pay rent to youor your partner?NoYesNoYesNoYes4Part 3Are they severelymentally impaired?About other people who live with you -continuedNoYesNoYesNoYesAre they in legal custodyat the moment?NoYes/When are theyexpected to comeout?NoYes/When are theyexpected to comeout?NoYes/When are theyexpected to comeout?///Are they in hospitalat the moment?NoYes/When did theygo in?NoYes/When did theygo in?NoYes/When did theygo in?///When are they expected tocome out?When are they expected tocome out?When are they expected tocome out?//////Do they normally work for16 hours or more a week?NoYesTell us theirearnings beforedeductions forthings like tax andNational Insurance.NoYesTell us theirearnings beforedeductions forthings like tax andNational Insurance.NoYesTell us theirearnings beforedeductions forthings like tax andNational Insurance.£££We need to see proofof their earnings.We need to see proofof their earnings.We need to see proofof their earnings.Do they have any otherincome at all?NoYesTell us their otherincome beforedeductions forthings like tax andNational Insurance.NoYesTell us their otherincome beforedeductions forthings like tax andNational Insurance.NoYesTell us their otherincome beforedeductions forthings like tax andNational Insurance.£££We need to see proofof their income.We need to see proofof their income.We need to see proofof their income.Read the Checklist at Part 17 to see what you can use as proof.5 [ Pobierz całość w formacie PDF ]