Page 135 - tmp

Part 1 - Personal Details (continued)

You Your Partner

Are you or your partner a student?

If ‘Yes’, please give us your student exemption certificate, which must include the name and length of the
course, year you are on, term dates and if it is full-time or part-time.

How many hours each week do you attend college?

Do you, or your partner, get Disability Living
Allowance/Personal Independence Payments
(PIP)?

How much do you get? Care £ Care £
Mobility £ Mobility £

Do you, or your partner, get Attendance [ ] NO
Allowance? Yes [ ] No [/] Yes [ ]
Do you, or your partner, have a vehicle from No [/] Yes [ ] NO
a Mobility Scheme? Yes [ ] [ ]

Are you, or your partner, registered blind? [ ] NO
Yes [ ] No [/] Yes [ ]

Are you, or your partner, long-term sick or
disabled? Yes [ / ] No [ ] Yes [ ] NO [ ]

Are you, or your partner, severely mentally
impaired? Yes [ / ] No [ ] Yes [ ] NO [ ]
Disabilities
Does anyone get Carers Allowance for
looking after you or your partner? Yes [ ] No [/] Yes [ ] NO [ ]

Have you or your partner been told that you
are entitled to Carers Allowance even if you
do not receive it because you are getting Yes [ ] No [/] Yes [ ] NO [ ]

another benefit instead?
Are you, or your partner, an apprentice?
Yes [ ] No [/] Yes [ ] NO [ ]

Do you, or your partner, pay towards the Yes [ ] No [/] Yes [ ] NO [ ]
upkeep of a student?

How much do you pay per week?

We need to see evidence of your Attendance Allowance and Disability Living
Allowance/Personal Independence Payments (PIP) - although these are disregarded you may
get more benefit if we know about them.
We also need to see proof of money you pay out.
44