Part 6: Your declaration
Joint claims for Jobseeker’s Allowance
If you have made a joint claim for Jobseeker’s Allowance either or both of you can sign
the declaration. Both of you are responsible for the information on this form.
You Your partner
I understand that
l if I knowingly give information that is incorrect or
incomplete, I may be liable to prosecution or other
action
l the information I have provided will be used to
process my claim. Some of the information may
be checked with other sources
l the information may be used for other purposes
relating to the work of the Department for Work
and Pensions. Some information may be given to
other government bodies as permitted by law.
I declare that the information I have given on this
form is correct and complete as far as I know
and believe.
What to do now
l Please make sure you send us everything we have
asked for with this form. If you cannot send
something we have asked for, tell us why in
Other information on page 11. But do not delay
sending us this form.
l Send this form back to us as soon as you can.
We may have to interview you if we need more
information.
l Make sure you and your partner, if you have one,
have signed and dated this form.
Signature
Date
Signature
Date
B16_102013_002_001
12
Please sign the form here after
printing
Please sign the form here after
printing
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