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ridhwaanali@hotmail.co.uk
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When your claim will start
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When we can contact you
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Please indicate any times you are not available for us to contact you within the
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8am til 12pm anytime after 12pm


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First name
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Ridhwaan
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Middle name
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0

Ahmed
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Surname
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Ali
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Relationship status
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Single
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Nationality
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
British
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrb \clbrdrl \ql

\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
National Insurance (NI) Number
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
JP284705B
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Where you live
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Are you in a residential care home, a nursing home or residential accommodation?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Contact information
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Your address status
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0

I have a permanent residential address


}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Where you live
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
4 Livesey Street, PRESTON, PR1 4JQ, England
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Would you like us to send your post to a different address?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Daytime contact number
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
07851110304
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452

0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Contact number type
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Mobile
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Is this a specially adapted phone for the deaf,
ed (known as a Textphone)?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you have another contact number?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Yes
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0

\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

hard of hearing or speech-impair


\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0


Please provide another number you can be contacted on
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
01772 513530
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
If you need us to provide an interpreter when we contact you, please select the
language required
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}\i0 \ri0 \fs24 \ql \cf1 \f0 \li0 \b0 \intbl \cell \row }}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Family and relationships
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you separated from someone who used to be your partner in the 26 weeks befo
re the date you want your claim to start?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Disability
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql

\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb


rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you ever been on the local authority register for blind persons?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Immigration
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you have to comply with immigration control rules on entry and residence in t
his country?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you have a right of abode in the UK?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Yes
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql

\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you returned to or arrived in the UK in the last two years?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Working or claiming benefits abroad
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you worked or claimed benefit outside the United Kingdom in the last five y
ears?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Tax and tax credits
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
What is your tax district number?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0

}\i0 \ri0 \fs24 \ql \cf1 \f0 \li0 \b0 \intbl \cell \row }
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
What is your tax reference number?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}\i0 \ri0 \fs24 \ql \cf1 \f0 \li0 \b0 \intbl \cell \row }
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Are you getting Child Tax Credit or Working Tax Credit?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Neither
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Work stoppage
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you been laid off, are you on short-time work or has work been temporarily
stopped
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240

Previous work
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you received, or do you expect to receive, any payments because a job ended
in the last 12 months?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you had any jobs that have ended in the last six months?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Education and training
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you been on any government or vocational (work-related) training scheme dur
ing the last four years?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l

{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0


{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Are you currently registered on a course of study?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you been a student during the last four years?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Yes
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Are you on Work Based Learning for Young People / Skillseekers?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}

{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1


{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Your previous study
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Other than courses you are currently registered on, how many courses have you be
en on in the last four years?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
2
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Please enter a name for your previous course 1 that can be used when asking furt
her questions
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
btec business
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Please enter a name for your previous course 2 that can be used when asking furt
her questions
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
btec it

}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
About your previous study: btec business
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
When did you start on this course?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
1 September 2008
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
When did you finish on this course?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
1 September 2009
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Did your local authority pay your course fees?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Yes

}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Was the course a sandwich course?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Was the course part-time?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
About your previous study: btec it
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
When did you start on this course?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
1 September 2009

}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
When did you finish on this course?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
20 June 2011
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Did your local authority pay your course fees?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Yes
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Was the course a sandwich course?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
\cellx4520 \ql

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrb \clbrdrl \ql

\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql


\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Was the course part-time?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Your pensions
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you received, or are you likely to receive, any payments made as part of th
e Armed Forces Compensation Scheme?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you receive a pension now, or expect to receive one in the next three years?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240

Current benefits
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you currently receive any benefits or help with mobility?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Potential benefits
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Are you waiting to hear about any benefits you\rquote ve claimed?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Previous benefits
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0

Have you made any other benefit claims before (other than those you are currentl
y receiving or waiting to hear about)?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you been on jury service in the last 12 weeks?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Caring
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Are you a carer for someone else?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0

{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0


Do you have a carer?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Carer\rquote s Allowance
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you stopped receiving Carer\rquote s Allowance in the last three months?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Your living arrangements
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you rent and/or own the place where you are living?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Neither
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0

\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80


0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
What are your living arrangements?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Parents
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Are you liable for paying the mortgage?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Are you liable for paying the rent on the whole
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0

\clpadfr3 \clbrdrl \ql \cellx452


\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

property?
\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrb \clbrdrl \ql
\clpadfr3 \clbrdrb \clbrdrr \ql

{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0


Have you moved house in the last 12 months?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
About the rent/mortgage
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Is your mortgage paid off?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Who is liable for paying the rent and/or mortgage?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Title : Mrs
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
First name : Husna
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}

{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0


Surname : Begum
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
What is your relationship to the person paying the rent and/or mortgage?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Parent
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Are they liable for the rent, the mortgage or both?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Mortgage
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Savings, investments and other income
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
How have you supported yourself in the last 12 months?
}

}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Family
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you have any National Savings Certificates?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Apart from your main home, do you own any property or land in this country or ab
road, even if it is on a mortgage?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Does anyone owe you any money?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l

{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0


{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Does anyone pay you rent for rooms or property?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you get any payments from a credit insurance policy?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Does anyone pay money to someone else on your behalf?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}

{\trowd \itap0 \trleft0


\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you get any maintenance payments?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrl \ql \cellx452
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrr \ql \cellx904
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you receive any other money from any source?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrl \ql
\cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrb \clbrdrr \ql
\cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Have you received any financial assistance towards the costs of a course of educ
ation which ended in the last three months or is still current?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Savings, investments and other income - shareholdings
\par
}

}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you own any shares?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Capital
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you have any of the following types of capital?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Bank account - savings? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Cash? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Premium bonds? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Bank account - current? : Yes
\par
}

{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0


}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
National Savings account? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Building society account? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Post Office account? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Unit trusts, ISAs, PEPs, TESSAs or other investments? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Money from the sale of a house? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Money saved for something? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Money from a redundancy payment? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Income bonds or capital bonds? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Money or property held in trust - including any trusts set up for your child(ren
)? : No
\par
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Other savings? : No
\par

}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
About your capital: Bank Account - Current
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
What is the value of this capital?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
\u163\'3f0
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Personal injury payments
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do any of the savings and investments you have include a lump sum from any perso
nal injury payment received by you within the last 52 weeks?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Education subsidies
\par
}
}{

{\trowd \itap0 \trleft0


\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you expect to receive any financial assistance towards the costs of a course
of education?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
Student upkeep
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Do you pay towards the upkeep of a student?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
No
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
About your Jobseeker\rquote s Allowance payments
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Please provide details of the account into which you would like to receive Jobse
eker\rquote s Allowance payments
}

}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Halifax, MR R A ALI, ****5490, 110618
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs32 \cf1 \f0 \li0 \b1
{\i0 \fs32 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb240
How you would like to get your Jobseeker\rquote s Allowance payments
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrl \ql \cellx4520 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrb \clb
rdrr \ql \cellx9040 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
How would you like to be paid Jobseeker\rquote s Allowance?
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \intb
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Pay into account
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs36 \cf1 \f0 \li0 \b1
{\i0 \fs36 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb280
Thank you for submitting your application
\par
}
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa200 \ul0 \cf1 \strike0 \f0 \b0 \sb240
Your application for Jobseeker\rquote s Allowance (JSA) has been submitted
\par
}
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa200 \ul0 \cf1 \strike0 \f0 \b0 \sb240
You will no longer be able to view your application online. If you need to make
any changes please contact Jobcentre Plus quoting your National Insurance Number
.
\par
}
}{
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80 \clpadfr3 \clbrdrt \clbrdrl \clb
rdrr \ql \cellx4520 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Jobcentre Plus (freephone):
}

}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0


}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
English:
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
0800 055 6688
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Welsh:
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
0800 012 1888
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
0 \ql
\intbl
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Textphone:
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
l
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
0800 023 4888
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0
}
{\trowd \itap0 \trleft0
\clpadb5 \clpadfb3 \clpadl5 \clpadfl3 \clpadr80
rdrr \ql \cellx4520 \ql
\intbl

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrl \ql \cellx452
\clpadfr3 \clbrdrr \ql \cellx904

\li0 \b0 \sb0 \intbl \cell \intb

\li0 \b0 \sb0 \intbl \cell \row


\clpadfr3 \clbrdrb \clbrdrl \clb

{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0


{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Monday to Friday 8.00 am to 6.00 pm
}
}\i0 \ri0 \fs24 \ql \sa0 \ul0 \cf1 \strike0 \f0 \li0 \b0 \sb0 \intbl \cell \row
}}
{\ri0 \i0 \ql \fs36 \cf1 \f0 \li0 \b1
{\i0 \fs36 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb280
Next steps: application interview and assessment
\par
}
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa200 \ul0 \cf1 \strike0 \f0 \b0 \sb240
A customer service adviser will phone or text you within two working days (Monda
y to Friday between 8:00am and 6:00pm) to arrange a \lquote new jobseeker interv
iew\rquote at your local Jobcentre Plus office. Following the interview, your a
pplication will be assessed and a decision will be sent to you in writing.
\par
}
}
{\ri0 \i0 \ql \fs36 \cf1 \f0 \li0 \b1
{\i0 \fs36 \sa240 \ul0 \cf1 \strike0 \f0 \b1 \sb280
What to bring to your interview
\par
}
}
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa200 \ul0 \cf1 \strike0 \f0 \b0 \sb240
Please bring the following to the interview along with your CV, if you have one:
\par
}
}\pard \fi-360 \li {\*\pn \pnlvlblt \ilvl0 \ls1 \pnindent0 \pnf1 {\f2 \pntxtb \u
8226\'3f}}\ls1 {\pntext }
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li480 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
A letter from the relevant Local Education Authority (or Authorities) confirming
that they paid the course fees for your previous study
\par {\pntext }
}
}\pard \pard \fi-360 \li {\*\pn \pnlvlblt \ilvl0 \ls2 \pnindent0 \pnf1 {\f2 \pnt
xtb \u8226\'3f}}\ls2 {\pntext }
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li480 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
Two forms of identification for you, such as driving licence, passport, mortgage
or rental agreement
\par {\pntext }
}
}\pard
{\ri0 \i0 \ql \fs24 \cf1 \f0 \li0 \b0
{\i0 \fs24 \sa0 \ul0 \cf1 \strike0 \f0 \b0 \sb0
\u160\'3f
\par
}
}
{\ri0 \i0 \fs28 \cf1 \f0 \li0 \qc \b1
{\i0 \fs28 \sa0 \ul0 \cf1 \strike0 \f0 \b1 \sb0
***** END PRINT *****
\par
}

}\sect }