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Part 10 About benefits and pensions

135. Are you or your partner or any children you are claiming for getting any benefits No Part 11.
or waiting to hear about benefits you have claimed?
Read the list of benefits below and tell us about any you or your partner are Tell us about the benefits
getting now or have claimed. below. Tell us the full rate
of the benefits before any
Adoption Pay • Maternity Allowance
deductions.
• Bereavement Allowance • NASS Payments
• Carer’s Allowance • Pension Credit (including savings credit)
• Child Benefit • Retirement Pension
• Children’s Tax Credit • Severe Disablement Allowance
• Contribution - Based Job Seekers Allowance • Social Service Subsistence Allowance
• Disabled Person's Tax Credit • Statutory Paternity Pay
• Fostering Allowance • Statutory Sick Pay or Statutory Maternity Pay
• Guardian’s Allowance • War Disablement Benefit, War Pension or War
• Incapacity Benefit Widow’s Pension
• Industrial Injuries Disablement Benefit • Widow’s or Widower’s Benefits
• Industrial Death Benefit • Working Tax Credit
• Invalid Care Allowance • Any other Benefit

If you are getting or have claimed any benefit that is not listed or If you are sending a separate sheet □
there is insufficient space below, tell us about it on a separate of paper, tick this box.
sheet of paper and send it with the form.

136. The name of the benefit your
child is claiming
Child's name

Waiting to hear • □
Getting now How much? • How much?

£ £
How often? How often?
Every Every
You Your partner

137. The name of the benefit or
pension □ □
Waiting to hear

Getting now • How much? • How much?
£ £
How often? How often?
Every Every

138. The name of the benefit

or pension □ □
Waiting to hear
Getting now • How much? • How much?

£ £
How often? How often?
Every Every

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