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BOON / NINEDAY
                     CICS Account and case numbers: 01623514 01623514



                      4


                     If you have answered NO to questions 1 & 2, please provide details of how you
                     pay your day to day living needs i.e. food, clothing, heating etc... If you are
                     supported by friends/family we will need to see evidence of this.


















                      5


                     Did / do you and your partner have any bank                Yes No
                     or building society accounts, savings or
                     investment during this period?

                     If Yes, please list them below and provide proof of the amounts
                     held for the above period. Please provide the last two full months
                     statements for every bank or building society for you and your
                     partner including the one that your Income Support or Job Seekers
                     Allowance was paid in to.



                                                                                £


                                                                                £

                                                                                £





















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