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BCON / NINEDAY
CICS Account and case numbers: 55508596 01623514

2.
Did / do you or your partner receive any other Yes No
income or benefits, such as state retirement

pension, tax credits or incapacity benefit?

If Yes, please list them below and provide proof

£

£

£

Have you applied for Working Tax Credit? Yes No

If Yes, when did you apply

3

Have you/your partner reapplied for

Income Support YES NO

Job Seekers Allowance YES NO

If YES, when did you reapply

If you have reapplied for benefit, it may not be continuous from the date
that your previous entitlement ended. Therefore, we will not be able to
pay you more benefit unless we have proof of your income
during these periods.

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