Page 82 - tmp

08/07/2008 16:33 02088031867 TULIP EFSS 03/10

BCONlNINEDAY
CICS Account and case numbers: 0162 5(514 01623514

Please write in black ink.

1:1 Details of income from 05/06/2008

Are you working? Yes [ ] No [ ]

, If Yes, how much are you paid
a week? £

Is you or your partner working? Yes [ ] No [ ]

If yes, how much is your partner paid? £

How Many hours do you work?

You must enclose your last 5 weeks two months consecutive payslips,
If you have Just started work and cannot provide any enough of them,
please also provide your employment contact or a letter from your

employ showing your pay details We may need to contact your
employer If we require further Information.
Can we contact your employer? Yes No

If Yes, please give their name, address and telephone number So, can
contact them direct. If you do not give us permission this may delay
your assessment.

74