Saughton House, Broomhouse Drive, Edinburgh, EH11 3UT
t / 0300 555 0505 w / www.saas.gov.uk
Household income for the tax year ending 5 April 2019
Who should fill in this form?
The parents, step parents, parent’s partner, legal guardians or husband, wife, civil partner or partner of the student
must fill in this form as a formal declaration of their income for the tax year ending 5 April 2019. If you received
state benefits, you must fill in Sections A to F. If you did not receive state benefits, you should only fill in Sections
A to D.
When you send us the form, you must also send us copies of documents as proof of the income you declared – for
example, P60, self-assessment or tax credit award/annual review. Please note that if you have already sent us this
proof, you do not need to send it again.
If you are not sure how to fill in the form or which documents to send us, please contact us on 0300 555 0505.
Section A – Student details
Section B – Your details: parents, step parents, parent’s partner, legal guardians / husband, wife, civil
partner or partner
Address (if different from
student’s home address)
If you are the student’s parent, step-parent or legal guardian and you are the only person named above, please tell us
why in the box below. For example, ‘single parent’.
Reason for one person’s details
If you have not already done so, you must send us a copy of one of the documents listed below as proof that you live
as a single person:
Your 2020-2021 tax credit award or
tax credit annual review for tax year
ending 5 April 2020.
A letter from the Jobcentre or Department for Work and Pensions which
clearly states you receive benefits as a lone parent. This must be on headed
paper and dated within the last three months.
Your council tax notice for 2020-2021
that shows a 25% discount.
A letter from your council or housing association that shows you have
been given the tenancy as a lone parent or are receiving housing benefit as a
lone parent. This must be on headed paper and dated within the last three
Your most recent Universal Credit
statement that shows you receive a
standard allowance as a single person.
A letter from a professional person who can confirm you live as a single
parent. This must be on headed paper and dated within the last three
A professional person can be a doctor, nurse, lawyer, solicitor, notary public,
teacher, counsellor, police officer, family mediation worker, social worker,
nursery teacher, student adviser or minister of religion.