Fillable 2020/21 Application form for Dependants Grants To find (Student Loans Company)

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2020/21 Application form for Dependants Grants To find (Student Loans Company)

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1
/
/
SFE/DEPG/2021/A
Application form for
2020/21
Dependants’ Grants
To find out how we’ll use the information you provide go to www.gov.uk/studentfinance to read our
Privacy Notice before completing this form.
Customer Reference Number
Name
Date of birth (DDMMYYYY)
Address
Postcode
Who should complete this form?
Complete this form if you want to apply for any of the following Dependants’ Grants:
• Parents’ Learning Allowance
• Childcare Grant
• Adult Dependants’ Grant
Also use this form if you have already applied for Childcare Grant and want to add additional children.
If you no longer need Childcare Grant for one or more of your children call us on 0300 100 0607.
For more information on Dependants’ Grants go to www.gov.uk/studentfinance
How do I complete this form?
• Answer every question in sections 1 & 2, then sign and date the declaration.
• If any questions do not apply to you, please write ‘N/A’ or ‘None’ as your answer.
• You need to send evidence with your application whenever you see this icon.
• If any questions are left blank we will not be able to process this application.
Any photocopied financial documents you send to us with this form will be securely
destroyed once we have checked them.
Where do I send my form?
Once you have completed this form, signed and dated the declaration, please return it to
Student Finance England
PO Box 210
Darlington
DL1 9HJ
2
SFE/DEPG/2021
£
Section 1
Student nancial questions
Unearned income
a Estimate the total taxable unear ned income,
before deductions, that you expect to
receive in academic year 2020/21.
What is the source of this income?
What is taxable unearned income?
Taxable unearned income is any income you receive from the following sources:
• Bank or building society gross interest • Trusts or sponsorships
• Property, lettings or rent
• Dividends or investments
• Any other payment received for attending
the course
Don’t include any:
• E
arnings from full or part-time work
• Maintenance Loan or grant payments you
may receive
• Payments you receive from parents under
a covenant
• Teacher Training Bursaries
• Higher Education Bursaries (for care leavers)
• Bounties paid by the armed services to
reservists or disablement or invalidity pensions
• ISAs
Payments from an employer
b Will you be employed during the
academic year?
No Yes
if no if no go to ego to e
c Will your employer be releasing you to
attend your course for the academic year
2020/21?
No Yes
if no go to e
If ‘Yes’, how much will your employer pay
you for time spent attending your course
during this period?
£
What should I include in my answer?
Only enter an amount for question b if you are being released from employment by your employer to
attend your course. Only include salary or wages that you will receive from that employer for days you are
attending your course.
Any earnings from salary or wages entered here may affect your student finance entitlement. Do not
provide any amount here if you are a student who is working while studying but have not been specifically
released by your employer to attend your course.
3
SFE/DEPG/2021
£
£
£
Section 1
Student nancial questions
d During the academic year 2020/21, will you
or your employer pay any money into a
pension fund on your behalf?
No Yes
if no go to e
If ‘Yes’, how much during this period?
Dependent children
e
When stating the child’s income, include their
income from all sources after income tax and
National Insurance contributions in tax year
2018-19.
Do include any income the child gets from:
• working
• interest earned on savings
• investments
• any maintenance payments
Don’t include income from:
• Child Benet
• Child Tax Credit or the childcare element of
Universal Credit
• Government Child Trust
Child 1 full name
Relationship to you
Date of birth (DDMMYYYY)
Who do they live with?
Income from all sources after income tax and
social security
You must provide
• copies of birth certicates; and
• evidence of Child Tax Credits and/or Child
Benets for each child named.
Child 2 full name
Relationship to you
Date of birth (DDMMYYYY)
Who do they live with?
Income from all sources after income tax and
social security
If you have more than two dependent children, give details for each additional child on the
additional notes at the end of this form.
4
SFE/DEPG/2021
Section 2
Parents’ Learning Allowance, Childcare
Grant and Adult Dependants’ Grant
a Are you under 25, living with a partner and
applying for Childcare Grant or Parents’
Learning Allowance?
No Yes
if no go to c1
b Give the total estimated income after Income
Tax and National Insurance deductions in
academic year 2020/21 for:
You Your partner
How much of this will be Child Tax Credit
or the child element of Universal Credit for
academic year 2020/21?
You Your partner
c1 Do you want to apply for Childcare Grant?
No Yes
if no go to d1
c2 During the academic year, do you or your
partner expect to receive:
• the childcare element of Working Tax Credit
or Universal Credit; or
• Tax-Free Childcare from HM Revenue and
Customs (HMRC); or
• Childcare Allowance from the National Health
Service (NHS) as part of a student finance
package?
No Yes – you can’t currently apply for
Childcare Grant.
You can only apply for
Childcare Grant if you stop
claiming support from any of
these sources.
c3 Give details of the children you need
Childcare Grant for during this academic year
• Only name children that you haven’t applied
for previously
• Childcare start date must not be earlier than
your academic year start date
Child 1
Forename(s)
Surname
Date of birth (DDMMYYYY)
Childcare start date (DDMMYYYY)
Child 2
Forename(s)
Surname
Date of birth (DDMMYYYY)
Childcare start date (DDMMYYYY)
If you need more space for additional children, give the details above on the additional
notes at the back of this form.
5
SFE/DEPG/2021
£
£
£
£
£
£
£
Section 2
Parents’ Learning Allowance, Childcare
Grant and Adult Dependants’ Grant
d1 Are you applying for Adult
Dependants’ Grant
No Yes
if no go to the
declaration on page 6
d2 Who is your adult dependant?
Your husband
Your wife
Your civil partner
Your partner
(if you are 25 or over)
go to the declaration
on page 6
other adult dependant
d3 Will your other adult dependant’s
income be more than £3,796 for the
academic year 2020/21?
No Yes
Applying for an Adult Dependants’ Grant
You will not be able to apply for Adult Dependants’ Grant if your other adult dependant’s income is more
than £3,796 in the academic year 2020/21.
d4 Give your adult dependant’s income for the
2018-19 tax year.
Income
All salary/wages and self-employed income (include
income from property)
All pension income (including private, occupational
and state)
If you receive a lump sum pension, only declare the amount
you received that you paid tax on.
All gross taxable income from interest, investments
and dividends
Taxable state benefits
All other taxable income
Deductions
Private pension contributions and Additional
Voluntary Contributions (AVCs)
Allowable expences on which tax relief was claimed
6
SFE/DEPG/2021
6
SFE/DEPG/2021
Declaration
• I confirm that to the best of my knowledge and belief, the information I have provided is true and
complete. If it is not I understand I may not receive financial support, any support I have received may
be withdrawn and I could be prosecuted.
• I agree to give the Student Loans Company Ltd (SLC) any information they require to process my
application and agree to tell them immediately if my circumstances change in any way that might affect
my entitlement to financial support. I understand that if I do not do this, I may not receive any further
payments, and may have to repay the financial support I have already received.
• I agree that in the event of receiving an overpayment of financial support, I am obligated to repay this in
full.
Childcare Grant
• I understand and agree that in order to receive Childcare Grant, my personal details and my children’s
details will be shared to a contracted third party who will be handling the administration of Childcare
Grants on behalf of SLC.
• I understand that if I do not inform SLC of any change of circumstances that affect the amount of
Childcare Grant I am entitled to, I will have to pay back any overpayment.
• I confirm that neither I nor my husband, wife, civil partner or cohabiting partner have chosen to receive
support for childcare from the childcare element of: (i) the Working Tax Credit; (ii), the Universal Credit;
(iii) Tax-Free Childcare; and/or (iv) the NHS Childcare Allowance; and I agree to tell SLC immediately if I
or my husband, wife, civil partner or cohabiting partner does receive this support. I understand that SLC
reserves the right to share my personal data with HMRC to check whether I am in receipt of childcare
support from HMRC.
Your full name (in BLOCK CAPITALS)
Your signature
Today’s date (DDMMYYYY)
7
SFE/DEPG/2021
7
SFE/DEPG/2021
Additional notes
If you are providing extra information please clearly mark what section and question the information
is about.
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202021 Application form for Dependants Grants To find (Student Loans Company)

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Completed 21 June 2021

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