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A claim form for Housing Benefit

and Council Tax Benefit ENFIELD
Council

If you are just claiming Second Adult Rebate*, only fill in Part
1, Part 3 and Part 19 of this form.
*See attached notes for explanation. Please fill in this form using black ink.
a
c
b
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n
k
.
k

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Part 1 About you and your partner
1. Do you have a partner who
normally lives with you?
By partner we mean someone
of the opposite sex/same sex
you are married to or live with
as if you were married.

2. Last name (Family Name)

3. Other names (first name(s))

4. Any other first or last names you
have used

5. Title (Mr, Mrs, Ms and so on)

6. Address
Do not tell us your partner’s
address if it is the same as
yours.

7. Date of birth

8. National Insurance number You
can find this on payslips or letters
from social security or the tax If you do not have a National If your partner does not have a
office. We cannot decide your Insurance number, or cannot find National Insurance number, or
claim if we do not have your it, tick this box. cannot find it, tick this box.
National Insurance number.

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