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Part 16 Anything else you need to tell us

Use the box below to tell us anything else you think we should know about. Use a separate sheet of paper and attach it to this form if you need
to.
If you are sending separate sheets of paper with this form, tell us how many.

Part 17 Checklist

Please tick to tell us what proof you are sending with this form. We must see original documents, not copies. Please do not send valuable
items through the post. If you can, bring them into our reception. We will take the details we need and give you the documents back
straightaway. If you cannot get into the office, phone us for more advice.

If you do not provide all the proof we need, we might not be able to pay you any benefit. We need the same proof for your partner, if you have
one, and for any other adults living in your home.
If you cannot send the proof we need at the moment, send the form back to us now and send the proof later. We can start to process your
claim, but we will not be able to pay you any benefit until we have all the proof. Please see accompanying notes for minimum amount of proof
required to process your claim.

Proof of identity - claimant and partner only - (one proof should include Date of Birth)
Such as a birth certificate, marriage certificate, passport, medical card, driving licence, UK residence □
permit, EEC identity card or recent paid gas or electricity bill. We may need to see several of these
documents for each person (minimum of 2 per person).
Proof of National Insurance number □
Such as a National Insurance number card, payslips or letters from social security or the tax office.
Proof of capital, savings and investments
Such as all your bank, building society or post office books, full bank statements, or certificates for premium
bonds, National Savings Certificates, ISAs, stocks, shares and unit trusts. We need to see proof of any
interest or dividends you get on investments and savings. We need to see this proof for children in your
household as well. The proof you send must show details for at least the last 2 months.
Proof of earnings - we also need this for any other adult living in your home
This means your last 5 payslips if you are paid every week, your last 3 payslips if you are paid every 2
weeks, or your last 2 payslips if you are paid every month. We will contact your employer If you do not have [ □
these payslips. If you or your partner are self-employed, we need to see your accounts for the last financial
year or, if you have been trading for less than 6 months, a summary of your trading records so far.
Proof of other income - we also need this for any other adult living in your home □
Such as pension slips from a former employer or a letter from the court showing how much maintenance
you are getting. We need to see proof of any money people pay you for board and lodgings.
Proof of benefits, allowances or pensions - we also need this for any other adult living in your home
Such as current award notices or letters from social security confirming how much you get. If you do not □
have proof, let us know straight away. Please do not send order books through the post.
Proof of private rent and tenancy
Such as a rent book, rent receipts, a tenancy agreement or a letter from your landlord. If owner occupier □
last two paid domestic bills or proof of mortgage payment.
Proof of other money paid out □
Such as letters about student grants or maintenance, agreements or receipts from registered child carers.

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