Fill - Free fillable PR1 2021/22 Application for Student Finance for continuing (London Institute of Management and Technology) PDF form

Application for

Student Finance for

continuing students

2021/22

PR1

Form

You can apply online at www.studentfinanceni.co.uk

Your forename(s)

Your surname

You should complete this form if you are continuing study on one of the following courses:

• A full-time or sandwich course of higher education

• A full-time Initial Teacher Training (ITT) course

• A part-time ITT course

• A flexible ITT course that lasts at least six weeks

• A diploma or degree course in a health related discipline and you are eligible to apply for

an income assessed bursary from the National Health Service (NHS) or the Department of

Health (DoH) or the Student Awards Agency Scotland (SAAS).

We have provided guidance notes to help you so please refer to these each time you see

this icon.

You will have to send evidence with your application whenever you see this icon.

Details about the evidence can be found in the guidance notes.

When do I send my form?

To make sure you receive your first payment at the start of term, you must return this form and

all of the evidence we need by 25 June 2021.

We will do our best to process your application as soon as possible, however if the deadline date

has passed, your first payment may not be ready for the start of term.

If your application form is returned more than 9 months from the start of your academic year it

won’t be processed, and you may lose your full entitlement to student finance for this

academic year.

To find out how we’ll use the information you provide go to

www.studentfinanceni.co.uk/privacy-notice to read our Privacy Notice before completing

this form.

You may be eligible for a bursary or scholarship. In order for a university or college to determine

and pay any bursary or scholarship to which you may be entitled, we will share some of your

personal, financial and course details as well as information about your eligibility for student

finance with them. For more information about this, read our Privacy Notice.

Please contact the university or college if you require further information about their bursaries

and scholarships.

NIR/PR1F/2122/A 1

Section 1 - nance available

All students can apply for the following student finance by completing this form:

• Maintenance Grant

• Parents’ Learning Allowance

• Special Support Grant

• Bursaries and Scholarships

• Maintenance Loan

• Travel Grant

• Tuition Fee Loan

• Childcare Grant

• Student Contribution Loan

• Disabled Students’ Allowance

• Adult Dependants’ Grant

You can find more detailed information on what is available and what you might be entitled to

at www.studentfinanceni.co.uk

What if I have questions?

If you have questions you can:

• visit www.studentfinanceni.co.uk

• call us on 0300 100 0077

Where do I send my form?

You must return your completed form to your local Student Finance NI (SFNI) office. You can

find their address at www.studentfinanceni.co.uk

Remember to pay the correct postage or we may not

receive your form.

2 NIR/PR1F/2122

Section 1 - nance available

Continued

You can apply in 5 easy steps

Depending on your circumstances you may not need to complete all of the steps.

For all students

• Complete sections 2-4.

• Remember if you are applying for a loan you need to tell us how much

you want by completing the loan request section on page 11.

• You do not need to complete section 4 if you are only applying for a

Tuition Fee Loan.

After you’ve completed Step 1 and if you only want to apply for a Tuition

Fee Loan or a Maintenance Loan not based on household income you

can go to Step 5.

For students who want student finance based on household income

• Complete sections 5 and 6.

If you think you qualify for Special Support Grant, please tick this box.

Detailed information about who can qualify for Special Support Grant and

what evidence needs to be provided can be found in the notes.

For students who have dependants

• Complete section 7.

• You should complete this section if you have any children or adult

dependants and want to apply for financial help in relation to them.

If you are a single independent student you should now go to Step 5.

NIR/PR1F/2122

Section 1 - nance available

Continued

For students who want student finance based on household income

• Complete section 8.

• Depending on your answers in section 8 you may need to ask your

parent(s) or partner to provide details about their income in section 9 so

we can work out what your full entitlement to student finance will be.

• If you do not wish to apply for student finance based on household

income, your parent(s) or partner do not need to complete section 9.

For all students

• Make sure that you read and sign the terms and conditions

on pages

17 and 18.

If you asked someone to complete section 9, make sure that they have

signed their declaration(s) on page 27.

Other student finance available

Childcare Grant (CCG)

If you want to apply for CCG you’ll need to:

• complete and return this form and

• complete an Application For Help With Childcare Costs (CCG1).

You can download the CCG1 form at: www.studentfinanceni.co.uk

Disabled Students’ Allowances (DSAs)

If you want to apply for DSAs you’ll need to:

• complete and return this form and

• complete a Disabled Students’ Allowances Application Form (DSA slim).

You can download the DSA slim form at: www.studentfinanceni.co.uk

Section 2 - personal details

Customer Reference Number

Personal details

Title Mr Mrs Miss Ms

Forename(s)

Surname

Any previous names you may be known by

Sex Male Female

Date of birth

Day Month Year

Contact details

Please give your current home address. If you know it, please also give your term-time

address.

Home address

Postcode

Term-time address

Postcode

Home phone number

Date you moved or will move to this address

Day Month Year

Mobile phone number

Email address

Current relationship status

c Tick one box below to show your status. Only send evidence if this has changed since

your last application.

Single (never married/civil partnership and not living with a partner)

Living with a partner

Married/civil partnership Please give the date of marriage/civil partnership

Day Month Year

Separated

Divorced/dissolved civil partnership

Widowed/surviving civil partner

Section 2 - personal details

Continued

Armed Forces

Are you a member of the Armed Forces serving outside

Northern Ireland?

Yes

d2 Are you a family member of someone in the Armed Forces

serving outside Northern Ireland?

(For example: spouse or child)

Yes

ction

Section 3 - about your course and your

university or college

Full tuition fee amount for this academic year

Please remember your tuition fee amount can change each academic year. If you are unsure

about the tuition fee amount you’ll be charged, speak to your university or college.

b Is this the final year of your course?

Yes

c Will you be studying at exactly the same university or college and on exactly

the same course that you were in academic year 2020/21?

Yes

if ‘Yes’ go to e2

If any of your course or university or college details have changed in any way since you

applied for student finance in the last academic year, you must complete all the questions in

this section with the new details.

Section 3 - about your course and your

university or college

Continued

d University or college details

University or college name and address

Postcode

UCAS personal identification number

UCAS university or college code

UCAS campus code (if applicable)

Course details

Course name

If you are following a combined studies or modular course, please list all subjects being studied

UCAS course code

Qualification you expect to

gain (for example, BSc Physics)

Course start date

Month Year

Course end date

Month Year

Course length (years)

Section 3 - about your course and your

university or college

Continued

Year of course

Foundation

First year

Second year

Third year

Fourth year

Other (give details)

If the course is franchised to another university or college, give their address below

Postcode

f Course type (please tick one box):

Full-time undergraduate

Initial Teacher Training (ITT) courses

Flexible postgraduate ITT

Part-time undergraduate ITT

Part-time IT T

(excluding first degrees)

Full-time postgraduate ITT

Answer both questions

Number of weeks you will be

studying full-time in this

academic year.

Number of weeks you will be

on full-time teaching practice in

this academic year.

Other course types

Full-time distance learning

Do you have a disability which prevents you

from attending your university or college in

person?

Yes

Full-time foundation degree

Full-time involving a placement

(sandwich course)

In this academic year, are you eligible to apply for a bursary, excluding social work bursary,

from any of the following?

• National Health Service (NHS)

• Department of Health (DoH)

• Student Awards Agency Scotland (SAAS)

Yes

g2 If ‘Yes’, is this bursary:

Income assessed

Non-income assessed

Section 3 - about your course and your

university or college

Continued

Term details

Where will you live during this academic year?

Term 1 Living with parent(s) Elsewhere or own home

Term 2 Living with parent(s) Elsewhere or own home

Term 3 Living with parent(s) Elsewhere or own home

Where will you spend most of your time this academic year?

Term 1 University or college Study abroad Work placement

Term 2 University or college Study abroad Work placement

Term 3 University or college Study abroad Work placement

if you have ticked ‘University or college’

for all 3 terms go to section 4

Will you be undertaking a placement as part of the

Erasmus+ exchange programme or a

government-funded mobility scheme established to

replace Erasmus+?

Yes

if ‘Yes’ and/or you’ll be studying abroad

go to section 4

Placement details

Where will your placement be?

Abroad

UK/ROI Don’t know

Placement name and address

Postcode

Is the placement:

paid

unpaid

If ‘unpaid’, please tick which type:

a hospital, Public Health Service Laboratory or a Primary Care Trust;

a Health Authority, Strategic Health Authority, Local Health Board, Special Health

Authority, Health Board, Special Health Board or a Health and Social Services Board;

a Local Authority carrying out its duties relating to health, welfare or caring for children and

young people, or a voluntary organisation providing facilities or carrying out similar activities;

the prison or probation sector or after-care services;

unpaid research in a UK/ROI or overseas institution; or

an unpaid placement

that is not listed above.

Section 4 - your UK bank or building

society account details

This account must be in your own name and be able to accept direct credits.

You do not need to provide your bank or building society account details if you are only

applying for a Tuition Fee Loan or Student Contribution Loan.

Please note that missing or incorrect bank or building society details will result in your

Maintenance Loan, bursary (if applicable) or any grant payments being delayed.

You can update your bank details at any time by logging into your student finance account

at www.studentfinanceni.co.uk

Sort code

Account number

Building society roll number (if applicable)

Loan request section

If you are applying for a Maintenance Loan, a Tuition Fee Loan or Student Contribution

Loan, please complete this section to tell us how much you want to apply for.

National Insurance number

We will share the National Insurance number you provide with the Department for Work and

Pensions to confirm that it’s valid, and with HM Revenue and Customs to allow us to collect

your repayments.

Maintenance Loan

Amount of Maintenance Loan

you would like to apply for:

Maximum available to you

Tick

If you wish to apply for less than the maximum

available to you, please state the amount

Tuition Fee Loan

Your tuition fee is set by the university or college you go to. You can apply for a Tuition Fee Loan to

cover your fees. This will be paid directly to your university or college.

Amount of Tuition Fee Loan

you would like to apply for:

Maximum available to you

Tick

If you wish to apply for less than the maximum

available to you, please state the amount

Student Contribution Loan

The Student Contribution Loan is for students studying on an undergraduate higher education

course at a relevant institution of higher education in the Republic of Ireland.

Amount of Student Contribution

Loan you would like to apply for:

Maximum available to you

Tick

If you wish to apply for less than the maximum

available to you, please state the amount

Contact details

We need you to give the name and address of two additional contacts. We’ll only contact

them if we can’t get in touch with you, for example if you move address and forget to tell us.

By entering these details, you’re confirming you’ve told your additional contacts about this and

they’re happy for the Student Loans Company Ltd (SLC) to contact them if necessary.

Contact 1

- -

Forename(s)

Surname

Relationship to you

Address

Postcode

Country

Phone number

Contact 2 (Contact 2 must live at a different

address from Contact 1)

Forename(s)

Surname

Relationship to you

Address

Postcode

Country

Phone number

Section 5 - dependent and independent students

This section determines whether you are a dependent or an independent student.

This is important as it establishes whose income we need to take into account from your

household before we calculate your entitlement.

a1 Will you be 25 or over on the first day of the academic year?

Yes

if ‘Yes’, you are an independent

student, go to section 6

a2 Have you been married or in a civil partnership at any

time before the first day of the academic year?

Yes

if ‘Yes’, you are an independent

student, go to section 6

a3 Will you have care of a person under the age of

18 on the first day of the academic year?

Yes

if ‘Yes’, you may be considered an

independent student, go to section 6

If you have previously been considered independent because you have supported yourself

financially for a total of 3 years or more prior to the start of the first academic year of your

course, you will continue to be considered independent.

if this applies to you go to section 6

b Please tick the relevant box if any of the following apply to you:

Your parents cannot be found or it is not reasonably practicable to get in touch with them.

You are irreconcilably estranged from (have no contact with) your parents and this will not

change.

At any point from the age of 16 to the start of your course, you have not been under the

legal care of your parents; and, for three months or more, you have been in the custody or

legal care of, or have been given accommodation by, a local authority.

Both your parents have died.

You have applied for student finance before, and the parent who was assessed for a

contribution has died.

Your parents are living outside the UK, Gibraltar or EU and the assessment of their

financial circumstances would place them in jeopardy.

Your parents are living outside the UK, Gibraltar or EU and it would not be reasonably

practicable or possible for them to send you money.

If you’ve ticked any of the boxes above, you will be contacted for evidence if your

situation has changed since last year and subject to this, you may be considered

independent.

If you haven’t ticked any of the boxes above you’re a dependent student.

‘

(£)

Section 6 - student nancial questions

If you leave any questions blank we will not be able to process your application. If a question

does not apply to you, please enter ‘None’ or ‘N/A’ as the answer.

Unearned income

a Taxable unearned income is any income you receive from the following sources:

• Bank or building society gross interest

• Property, lettings or rent

• Dividends or investments

• Trusts or sponsorships

• Any other payment received for attending the course

Please estimate the total taxable unearned income, before

deductions, that you expect to receive in this academic year.

What is the source of this income?

Payments from an employer

b1 Will your employer be releasing you to attend your course

this academic year?

Yes

if ‘No’ go to c

If ‘Yes’, how much will your employer pay you for time spent

attending your course during this period?

b2 During this academic year, will you or your employer

pay any money into a pension fund on your behalf?

Yes

If ‘Yes’, how much during this period?

Dependent children

c Give details of any children who will be wholly or mainly financially dependent on you during

this academic year.

Your child’s income should include their income from all sources for tax year 2019-20

after Income Tax and social security contributions.

Child’s full name Date of birth

(DD MM YYYY)

Relationship

to you

Who will they

live with?

Child’s

income

Section 7 - Parents’ Learning Allowance, Adult

Dependants’ Grant and Childcare Grant

Only complete this section if you want to apply for Parents’ Learning Allowance, Adult

Dependants’ Grant or Childcare Grant.

a Are you a lone parent?

Yes

if ‘Yes’ go to d

b Are you under 25, living with a partner and applying for

Childcare Grant or Parents’ Learning Allowance?

Yes

if ‘No’ go to d

c Give the total estimated income after Income Tax and National Insurance deductions in

this academic year for:

You Your partner

How much of this will be Child Tax Credit or Universal Credit for this academic year?

You Your partner

Only answer this question if you are applying for Childcare Grant.

d 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

• a healthcare bursary or Scottish Healthcare Allowance

Yes

If ‘Yes’, you can’t get Childcare Grant and receive childcare support from one

of these sources at the same time. You can still apply for Childcare Grant,

however, you’ll only get it if you stop receiving support from these sources.

e1 Are you applying for Adult Dependants’ Grant?

Yes

if ‘No’ go to f

e2 Who is your adult dependant?

husband,

wife,

civil partner or

partner (if you are over 25)

go to section 8

other adult dependant

go to e3

Will your other adult dependant’s income be more

than £3,873 in this academic year?

Yes

If ‘Yes’ you won’t be able to receive Adult Dependants’ Grant

Section 7 - Parents’ Learning Allowance, Adult

Dependants’ Grant and Childcare Grant

Continued

Give your other adult dependant’s income for tax year 2019-20

Income

All salary/wages and self employed income

(including income from property)

All income from pensions (including private, occupational and

state)

All gross taxable income and interest from savings,

investments and dividends

Taxable state benefits

All other taxable income (including redundancy

payments and compensation for loss of job)

Deductions

Private Pension contributions and

Additional Voluntary contributions (AVCs)

Allowable expenses on which tax relief is claimed

Section 8 - about your family

If you are a dependent student, go to question a.

If you are an independent student with a partner, go to the terms and conditions on

pages 17 and 18 and then pass this form to your partner to complete section 9.

If you are a single independent student, go to the terms and conditions on pages 17

and 18.

With which parent do you normally live, or have more contact?

Mother Father

What is the relationship status of this parent

at the time of applying?

Single (never married/civi

l partnership

and not living with a partner)

Living with a partner

Married/civil partnership

Separated

Divorced/dissolved civil partnership

Widowed/surviving civil partner

Have your parents divorced, separated

or been in a civil partnership which has

been dissolved, since 1 September 2020?

Yes

Now please read and sign the terms and

conditions on pages 17 and 18 and then

pass this form to the person(s) who you

have indicated in ‘question a’ to complete

section 9.

Both N/A

What you need to do next

Read and sign the terms and

conditions on pages 17 and

18 and

then pass this form to your parent(s).

What your parent(s) need to do

The parent(s) you normally live with

should complete section 9. If the

parent indicated in ‘a’ is married, in a

civil partnership or living with a partner,

their partner must also complete

section 9.

If the parent indicated in ‘a’ is

Divorced/dissolved civil partnership,

Separated or Widowed/a surviving

civil partner but currently living with

a partner their partner must also

complete section 9.

Terms and Conditions

These terms and conditions (“terms”) and

applicable legislation apply to all of the student

finance available to students for the academic year

2021/22.

I understand that I must read the specific terms

about the student finance products available

because they will affect me if I apply for them at

any time in this academic year.

I understand that my application for student

finance may be delayed unless I sign and date

these terms.

Loan Contract

1. I confirm I have read and understood these

terms and A Guide to Terms and Conditions

available at www.studentfinanceni.co.uk/

terms-and-conditions

2. 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 that I

may not receive student finance, any support

I have had may be withdrawn and I could be

prosecuted.

3. I understand that student finance is provided

to me by the Department for the Economy (the

“Lender”) which includes any persons acting

on its behalf and any replacement(s) under

Article 4(3) of the Education (Student Support)

(Northern Ireland) Order 1998 as amended or

replaced from time to time (the “Order”).

4. I understand these terms, the Order and the

regulations made under Article 3 of the Order

will apply to any student finance provided to

me by the Lender.

5. I understand that “student finance” in these

terms means financial support by way of

grant(s) and/or loan(s) made by the Lender

under the regulations.

6. I understand that the Student Loans Company

Limited (“SLC”) and the Education Authority

(“EA”) carry out certain functions on behalf of

the Lender.

My Obligations

7. I understand that if I have:

i. reached the age of 18 years; and

ii. have entered into agreement(s) for a loan

under the Order before I reached the age

of 18 years,

I am agreeing to “ratify” any and all such

student loans by signing these terms.

This means that I confirm I entered into

agreement(s) with the Lender and agree to

the terms of any such previous agreement(s).

If I have reached the age of 18 and refuse

to “ratify” any previous agreement(s), I

understand that I will not be eligible to get any

further student finance under the regulations.

8. I agree to give SLC and EA any information

they need in support of this application for

student finance and to seek repayment.

9. I agree to tell SLC and EA immediately if my

circumstances change in any way that might

affect my entitlement to student finance. I

understand that if I do not do this I may not get

any further payments and I may have to repay

the student finance I have already received.

I agree that from the date I submit my

student finance application until my loan(s),

together with all and any interest, penalties

and charges which apply, is fully repaid I

must tell SLC and EA about any changes in

my personal details (including my National

Insurance number) and contact details I have

provided.

10. I agree that if I get an overpayment of student

finance, I need to repay this in full and that

any overpayment may be taken from any

future entitlement to student finance.

11. I agree that I will repay the Lender any loan(s),

together with all and any interest, penalties

and charges which apply. I understand that

this repayment will be due by me to the

Lender as a debt. If I breach any of the terms

of my loan, I agree to pay any charges and

penalties which apply under the Order and

the regulations. I understand that I will repay

my loan(s) through the United Kingdom (“UK”)

tax system and/or I may repay SLC directly.

If I live abroad, I will repay my loan(s) to SLC

directly.

NIR/PR1F/2122

12. I agree that any loan(s) made to me in

accordance with the regulations once my

application is accepted by the Lender is a/

are contract(s) between me and the Lender. I

understand that I am liable for my loan(s) and

will be charged interest from the first payment

of the loan advance by the Lender.

13. I agree to tell SLC if I leave the UK to live

outside the UK or if for any other reason I am

outside the UK tax system for more than three

months.

Legal Action and Applicable Law

14. In the event of any legal action, I agree that

the laws of Northern Ireland will apply and

that the courts of that part of the UK will hear

any legal action. If my address is outside the

UK the laws of the part of the UK where my

education provider is situated will apply and

the courts of that part of the UK will hear any

legal action. I agree that the Lender has the

right to take legal action against me in any

other court with jurisdiction.

Sharing Information

15. If I am in breach of these terms and/or the

regulations I agree that the Lender may share

information held about me and my account

with third parties, including the government or

a government agency of another country, who

may help to locate me and/or help take action

to recover any payments I owe.

16. I confirm where I have provided any personal

information about any other person in my

student finance application, I have done so

with their consent.

17. I understand that SLC will process my

personal data in line with the Privacy Notice

available at www.studentfinanceni.co.uk/

privacy-notice which may be updated from

time to time.

Disabled Students’ Allowances (“DSAs”)

This section applies if I apply for DSAs this

academic year.

18. I understand that any equipment I receive

through DSAs must be used for my course

of study and that I am responsible for paying

any repair costs.

19. I understand SLC reserves the right to pay

the suppliers of any approved equipment and

support directly. I will be notified if SLC will

make payments directly to suppliers on my

behalf.

Childcare Grant (“CCG”)

This section applies if I apply for CCG this

academic year.

20. I understand that if I do not provide the

evidence of childcare costs within the

timescales set, I may lose my entitlement.

If my childcare costs are different from the

estimates I have provided, further payments

of my CCG may increase or decrease

accordingly. If no further CCG payments are

due to be paid to me, I may be liable to repay

any difference.

21. I understand that if I do not take up my

childcare, or if I change to a childcare provider

who is not registered or approved, I will have

to pay back any overpayment.

22. I confirm that neither I nor my husband,

wife, civil partner or cohabiting partner have

chosen to receive support for childcare from:

i. the childcare element of Working Tax

Credit;

ii. the childcare element of Universal Credit;

iii. Tax-free Childcare; or

iv. a healthcare bursary or Scottish

Healthcare Allowance;

and I agree to tell the EA and SLC immediately

if I or my husband, wife, civil partner or

cohabiting partner does receive this support. I

understand that SLC may share my personal

data with HMRC to check whether I get

childcare support.

Customer Reference Number

Your full name

(in BLOCK CAPITALS)

Your signature

Today’s

date

Day Month Year

The relevant person(s) you indicated in section 8 must complete section 9, as well as the

declaration(s) on page 27.

Please pass this form to them now.

If you are a single independent student please go to page 29 to finalise your application.

Section 9 - nancial details for tax year 2019-20 for

parents and partners

Who needs to complete this section?

Section 8 of this form tells you who needs to complete this section.

What details do I need to provide in this section?

You need to tell us some personal details and what your financial income was for tax year

2019-20. You must tell us your 2019-20 income details as we cannot accept amounts from

any other tax year. We need your income amounts so we can work out what the student(s)

you are supporting is entitled to.

To find out how we’ll use the information you provide go to

www.studentfinanceni.co.uk/privacy-notice to read our Privacy Notice before completing

this form.

About this section

Section 9 is split into five parts:

Part A - Tell us your name and address and some other personal information.

Parts B and C - Answer every question.

Part D - Answer every question and tell us about any income deductions for tax year

2019-20 where appropriate.

Part E - Tell us about any children who are financially dependent on you.

How to complete this section

If you are a single parent of the student

Enter your information as Person 1, leave Person 2 blank.

If there are two parents, or a parent and a partner, in the student’s household

Complete this section with information for both Person 1 and Person 2.

If you are an independent student with a partner

Your partner needs to enter their information as Person 1, leave Person 2 blank

If you’re self assessed – read page 13 of the notes for more information.

If you’re not self assessed – you can use your P60 to complete this section.

What happens if my household income has dropped since tax year

2019-20?

If your household income has dropped by 5% or more since tax year 2019-20 you can apply

for a ‘Current Year Income Assessment’.

This means we would use your expected income for tax year 2021-22 instead of your actual

income from tax year 2019-20 when calculating the student’s entitlement. However, there

must be at least a 5% drop in the overall household income (not just your own income)

between these two tax years for us to do this and we will ask for evidence of your 2021-22

income at the end of that tax year.

Section 9 - nancial details for tax year 2019-20

for parents and partners

Continued

Part A – Your personal details

Person 1

Your Customer Reference Number

(If you have one)

Relationship to the student

Title

Forename(s)

Surname

Date of birth

Place of birth

(name of town or village exactly as it appears

on your birth certificate or passport)

Home address

Postcode

Home telephone number

Email address

Person 2

Your Customer Reference Number

(If you have one)

Relationship to the student

Title

Forename(s)

Surname

Date of birth

Place of birth

(name of town or village exactly as it appears

on your birth certificate or passport)

Home address

Postcode

Home telephone number

Email address

You do not have to disclose your financial information to the student.

If you would like to provide it separately, download a Continuing Student Assessment of Financial

Circumstances form 2021/22 from www.studentfinanceni.co.uk and return it to us.

££

Section 9 - nancial details for tax year 2019-20

for parents and partners

Continued

Part B - Your financial information

Do not submit any evidence in support of the financial information you provide in this

section. However, it is important that you keep all evidence relating to tax year 2019-20, as

you may be asked to provide us with this evidence at a later date.

If you are the student’s parent,

step-parent or parent’s partner, you

must answer this question.

Give your total gross taxable income

(before deductions) from all sources

received from 6 April 2019 to 5 April 2020.

Person 1

Person 2

Total gross taxable income

go to Q2a

If you are the student’s partner,

you must answer this question.

Give your total gross taxable income

(before deductions) from all sources

received from 6 April 2019 to

5 April 2020.

Total gross taxable income

go to Q2a

Instructions

• Please give gross financial details

for tax year 6 April 2019 to 5 April 2020.

• Answer ‘Yes’ or ‘No’ to every question, if you answer ‘Yes’ please provide the income amount.

Please note that if you leave any questions blank we will not be able to

process this application.

Q2a Did you receive Working Tax Credit, Child Tax

Credit or Universal Credit?

Person 1

Yes No

Person 2

Yes No

Q2b Did you receive Income Support or ESA?

Yes No

Section 9 - nancial details for tax year 2019-20

for parents and partners

Continued

Q3 Did you receive any income from salary, wages,

taxable state benefits or from occupational or private

pensions?

Person 1

Yes No

Person 2

Yes No

Total income from salary / wages

b Total income from taxable state benefits

c Total income from occupational pension(s)

If you receive a lump sum pension, only declare the amount you

received that you paid tax on.

d Total income from private pension(s)

If you receive a lump sum pension, only declare the amount you

received that you paid tax on.

Q4 Did you receive any income from a state retirement

pension?

Person 1

Yes No

Person 2

Yes No

a Total lump sum amount received

b Total non-lump sum amount received

Q5 Did you receive any income from savings and

investments?

Person 1

Yes No

Person 2

Yes No

a Total interest from UK banks, building societies and

unit trusts

b Total income from UK life insurance gains, securities

and partnerships

c Total income from UK investments and dividends

d Total income from foreign investment and dividends

Total taxable income minus expenses that are not

included on your P60 or P11D

Section 9 - nancial details for tax year 2019-20

for parents and partners

Continued

Q6 Did you receive any taxable benefits in kind?

Person 1

Yes No

Person 2

Yes No

Total income received from taxable benefits in kind

Q7 Did you receive any other income during tax year 2019-20 that you haven’t yet told

us about?

Person 1

Yes

Go to Part C

Go to Part D

Person 2

Yes

Go to Part C

Go to Part D

Part C - Other income

Instructions

• Complete Part C in the same way you completed Part B giving gross financial details for

tax year 6 April 2019 to 5 April 2020.

Person 1

Person 2

Q1 Did you receive any income from

self-employment?

Yes No

a Total adjusted profit from businesses

b Total

adjusted profit from partnerships

Q2 Did you receive any income as

a Minister

of religion?

Yes No

Section 9 - nancial details for tax year 2019-20

for parents and partners

Continued

Person 1

Person 2

Q3 Did you receive any other taxable income or lump

sums?

Yes No

Total income received

Q4 Did you receive any income

from

property lettings?

Yes No

Total income received

Did

you receive any income

from UK trusts?

Yes No

Total income received

Q6 Did you receive any foreign income?

Yes No

Total income received

Q7 Did you receive any

income from an overseas

pension?

Yes No

Total income received

Did you receive any other overseas income

and gains?

Yes No

Total income received

Section 9 - nancial details for tax year 2019-20

for parents and partners

Continued

Part D – Income deductions

Instructions

•

Complete Part D in the same way you completed Part B giving gross financial details for

tax year 6 April 2019 to 5 April 2020.

Person 1

Q1 Did you pay any private pension contributions?

Yes No

Person 2

Yes No

Total amount you paid

Q2 Did you pay any Additional Voluntary Contributions

(AVCs)?

Person 1

Yes No

Person 2

Yes No

Total amount you paid

Did you have any allowable expenses on which

you claimed tax relief?

Person 1

Yes

Person 2

Yes No

Total amount on which you claimed tax relief

Section 9 - nancial details for tax year 2019-20

for parents and partners

Continued

Part E – Your dependants

Identify any children who will be wholly or mainly financially dependent on you.

Q1 Child dependants not in further or higher education in academic year 2021/22

Include unearned income for all dependants. Only include earned income details for

persons aged 16 and over. Do not count casual earnings of persons under 16.

Full name

Date of birth

(DD MM YYYY)

Income for the year

Q2 Child dependants in further or higher education in academic year 2021/22

Do not include the applicant when completing this question.

If the student is your partner, please include any children they named in section 6 of this

form if the children have applied for student finance.

Full name

Date of birth

(DD MM YYYY)

School, college or

university

Course

Are they receiving

financial support?

If so, from which

authority or

organisation?

Declaration for parents and partners

Before signing, you should read the Privacy Notice in the notes that accompany this form.

This application for financial support may be delayed unless you sign and date this 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 the student I am supporting may have their financial

support withdrawn and I may be prosecuted.

• I agree to supply any further information in relation to the applicant’s application for financial

support that my local Student Finance NI (SFNI) office may ask for and agree to tell them

immediately if my circumstances change in any way that might affect this application for

financial support.

Person 1

Your full name (in BLOCK CAPITALS)

Your signature

Today’s date

Day Month Year

Person 2

Your full name (in BLOCK CAPITALS)

Your signature

Today’s date

Day Month Year

The student may be eligible for a bursary or scholarship. In order for a university or college

to determine and pay any bursary or scholarship to which the student(s) you are supporting

may be entitled, we will share some of your personal and financial details with them. For more

information about this, read our Privacy Notice.

Deadline

To make sure the student receives their first payment at the start of term, this form must be

returned with all of the evidence we need by 25 June 2021. We will do our best to process

this application as soon as possible, however if the deadline date has passed, the first

payment may not be ready for the start of term.

Now pass this form back to the student.

Additional notes

If you are providing extra information below please clearly mark what section and question the

information is about.

Checklist

Before returning this form, please make sure you have done the following:

Fully answered all questions that apply to you.

Enclosed all the documents we have asked for as evidence where you have seen

this icon next to a question.

Completed the loan request section if you are applying for a Maintenance Loan, Tuition

Fee Loan or Student Contribution Loan.

Signed and dated the relevant terms and conditions.

Asked your parent(s), parent and partner, or your partner to complete section 9 if applying

for student finance based on your household income.

When your completed application form with all the relevant evidence has been processed you

will be sent a letter showing the amount of financial support you will receive.

Remember to pay the correct postage or we may not receive

your form.

You must return your completed form to your local Student Finance NI (SFNI) office.

You can find their address at www.studentfinanceni.co.uk

Additional notes

If you are providing extra information below please clearly mark what section and question the

information is about.

Additional notes

If you are providing extra information below please clearly mark what section and question the

information is about.

Additional notes

If you are providing extra information below please clearly mark what section and question the

information is about.

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PR1 202122 Application for Student Finance for continuing (London Institute of Management and Technology)

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