1
SFE/PR1F/2122/A
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PR1
Application for student nance
- continuing students
2021/22
Forename(s)
Surname
Refer to the guidance notes when you see this icon. The notes will give you extra
information to help you complete the form correctly.
You will have to send evidence with your application whenever you see this icon.
Details about the evidence required can also be found in the guidance notes.
You should complete this form if you are continuing study on one of the following courses:
A full-time course of higher education.
A full-time sandwich course of higher education.
A full-time Initial Teacher Training (ITT) course.
A full-time distance learning course (if you are starting a full-time distance learning course,
for reasons not relating to disability, you can apply for a Tuition Fee Loan and Disabled
Students’ Allowance (DSA) only).
A diploma or degree course in a health-related discipline and you are eligible to apply for an
income-assessed bursary from NHS England or NHS Wales.
A degree course in nursing, midwifery or an allied health profession (including operating
department practice).
A diploma in operating department practice.
A pre-registration postgraduate healthcare course.
A degree, diploma or foundation degree in dental hygiene, dental therapy or dental hygiene
and dental therapy.
Deadline
To make sure you receive your rst 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 rst payment
may not be ready for the start of term.
If your application form is returned more than 9 months after the start of your academic year it
won’t be processed, and you may lose your full entitlement to student nance.
You can apply in 5 easy steps
Depending on your circumstances you may not need to complete all of the steps.
1
For all students
• Complete sections 2-4.
• You do not need to complete section 4 if you are only applying for a Tuition Fee Loan.
• If you are applying for a Maintenance Loan, Special Support Loan and/or a Tuition
Fee Loan you need to tell us how much you want by completing the loan request
section on pages 10 and 11.
If you only want to apply for a Tuition Fee Loan and/or a Maintenance Loan that is
not based on household income you can go to Step 5.
2
For students who want student finance based on household income
Complete sections 5 and 6.
If you want to apply for Special Support complete section 7.
• If you’re aged 60 or over on the rst day of the rst academic year of your course
and are applying for student nance based on your household income, you’ll be
assessed for a Special Support Loan instead of a Maintenance Loan. You don’t
need to complete section 7.
3
For students who have dependants
Complete section 8.
You should complete this section if you have any children or adult dependants and
want to apply for nancial help in relation to them.
If you are a single independent student go directly to Step 5.
4
For students who want student finance based on household income
Complete section 9.
Depending on your answers in section 9 you may need to ask your parent(s) or
partner to provide details about their income in section 10 so we can work out what
your full entitlement to student nance will be.
5
For all students
Make sure that you have signed the terms and conditions on pages 18 and 19.
If you asked someone to complete section 10, make sure that they have signed
their declaration(s) on page 28.
What if I have further questions?
If you have further questions you can:
• visit www.gov.uk/studentfinance
• call us on 0300 100 0607
2
SFE/PR1F/2122
Section 1
Finance available
If you started your course on or after 1 August 2016 you could get:
Tuition Fee Loan Special Support Loan (if you were aged 60
or over on the rst day of the rst academic
year of your course)
Maintenance Loan
If you started your course on or after 1 September 2012 and before 1 August 2016 you
could get:
Tuition Fee Loan
Maintenance Grant
Maintenance Loan
Special Support Grant
Extra help
You can also apply for additional student nance:
Childcare Grant
Bursaries and Scholarships
Disabled Students’ Allowance
Parents’ Learning Allowance
Adult Dependants’ Grant
Travel Grant
Disabled Students’ Allowance (DSA)
If you applied for DSA last year you only need to complete this form (PR1). You do not need to
reapply for DSA.
If you want to apply for DSA for the rst time you’ll need to:
• complete and return this form; and
• complete a Disabled Students’ Allowance Application Form (DSA slim).
You can download the DSA slim form at: www.gov.uk/studentfinance
Tick the box below if you want us to send you a DSA slim form instead.
Send me a DSA slim form
Go to www.gov.uk/studentfinance to nd out more about what student nance is available.
Before completing this form, you should read the Privacy Notice on page 14 of the
accompanying notes.
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, nancial and course details as well as information about your eligibility
for student nance 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.
SFE/PR1F/2122
3
4
- -
Section 2
Personal details
Customer Reference Number
Personal details
a
Title Mr Mrs Miss Ms
Forename(s)
Surname
Sex Male Female Date of birth
Day Month Year
National Insurance number
We will share the National Insurance number you provide with the Department for Work and
Pensions to conrm that it’s valid, and with HM Revenue and Customs to allow us to collect
your repayments.
Contact details
b Please give your current home address. If you know it, please also give your term-time
correspondence address.
Home address
Postcode
Term-time address
Postcode
Home phone number
Date on which you will move to this address
Day Month Year
Mobile phone number
Email address
Current relationship status
c
Tick one box. You only have to send evidence if your circumstances have changed
since your last application.
Single
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
Armed Forces
d1 Are you a member of the Armed Forces serving outside England?
Yes
No
d2 Are you a family member of someone in the Armed Forces
outside England? (for example: spouse or child)
Yes
No
5
£
Section 3
About your course and university
or college
a Full tuition fee amount for this academic year
Your tuition fee amount can change each year. If you are unsure about the tuition fee amount
you will be charged, contact your university or college.
b Is this the nal year of your course?
Yes
No
c Will you be studying at exactly the same university or college and on exactly the
same course that you were in the academic year 2020/21?
Yes
No
if yes go to f
You must complete all of the questions in this section if any of your course, university or
college details have changed since your last application.
University or college details
d
University or college name and address
Postcode
UCAS personal identication number
UCAS university/college code
UCAS campus code (if applicable)
Course details
e Course name
If you are following a combined studies or modular course, please list all subjects being studied
UCAS course code
Qualication you expect to
gain (e.g. BSc Physics)
Course start date
Month Year
Course end date
Month Year
Course length (years)
Year of course
Foundation
First year
Second year
Third year
Fourth year
Other (give details)
6
Section 3
About your course and university
or college - continued
If the course is franchised to another university/college, give the address of the other
university/college
Postcode
f
Which of the following is your course? Tick one box only.
Full-time undergraduate
Full-time Initial Teacher Training (ITT)
courses of up to 2 years in length
Full-time foundation degree
Full-time distance learning
Full-time involving a placement
(sandwich course)
Do you have a disability which prevents
you from attending your university
or college in person?
Yes
No
7
Section 3
About your course and university
or college - continued
g1 In this academic year, are you eligible to apply for a bursary
(excluding a social work bursary) from any of the following?
Yes
No
• National Health Service (NHS)
• Department of Health and Social Care (DHSC)
• Student Awards Agency Scotland (SAAS)
g2 If ‘Yes’, is this bursary or award income assessed or non-income assessed?
Income assessed Non-income assessed
Term details
h Where will you be living during term time?
We need to know about your living situation for each term as this can affect how much
student nance you can get.
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
i Where will you spend the most time during the 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
j Will you be undertaking a placement as part of the Erasmus+
exchange programme or a government-funded mobility scheme
established to replace Erasmus+?
Yes
No
if yes or you’ll be studying abroad go to section 4
k Where will your placement be?
Abroad
UK
Don’t know
Placement name and address, if known
Postcode
8
Section 3
About your course and university
or college - continued
l Is the placement:
paid
unpaid
e
If ‘unpaid’, please tick which type:
a hospital, Public Health Service Laboratory or with Clinical Commissioning group in
the UK;
a Special Health Authority, the National Health Service Commissioning Board, the
National Institute for Health and Care Excellence, the Health and Social Care
Information Centre, Local Health Board, Health Board, Special Health Board or
Health and Social Services Board in the UK;
a Local Authority carrying out its duties relating to health, welfare or caring for
children and young people, a voluntary organisation providing facilities or carrying
out similar activities or a Local Authority acting in the exercise of public health
functions in the UK;
the prison or probation sector or after-care services in the UK;
unpaid research in a UK or overseas institution;
an unpaid placement in the Houses of Parliament; or
an unpaid placement that is not listed above.
9
Section 4
Your bank or building society
account details
This account must be in your own name (not a joint account) and be able to accept
direct credits.
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 do not need to provide your bank or building society account details if you are only
applying for a Tuition Fee Loan because this will be paid directly to your university or
college and not to you.
Sort code
Account number
Building society roll number (if applicable)
10
Loan request section
If you are applying for a Maintenance Loan, Tuition Fee Loan or Special Support Loan, please
complete this section to tell us how much you want to apply for.
Maintenance Loan
Amount of Maintenance Loan
you would like to apply for:
Maximum available to you
If you wish to apply for less than the maximum
available to you, please state the amount.
Special Support Loan
The Special Support Loan is awarded instead of the Maintenance Loan for students who are aged
60 and over on the rst day of the rst academic year of their course and started their course on
or after 1 August 2016.
Amount of Special Support Loan
you would like to apply for:
Maximum available to you
If you wish to apply for less than the maximum
available to you, please state the amount.
n
Tuition Fee Loan
£
n
£
Your tuition fee is set by the university or college you go to. Any Tuition Fee Loan you borrow will
be paid directly to your university or college. You should nd out how much your university or
college is charging before you apply for a Tuition Fee Loan.
Amount of Tuition Fee Loan
you would like to apply for:
Maximum available to you
If you wish to apply for less than the maximum
available to you, please state the amount.
£
11
Loan request section - continued
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 conrming you’ve told your additional contacts about this
and they’re happy for Student Loans Company Ltd (SLC) to contact them if necessary.
Contact 1
Forename(s)
Surname
Relationship to you
Address
Postcode
Phone number
Contact 2
(contact 2 must live at a different
address from contact 1)
Forename(s)
Surname
Relationship to you
Address
Postcode
Phone number
If you don’t want student finance based on your household income go straight to the terms
and conditions on pages 18 and 19.
12
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.
a
1 Will you be aged 25 or over on the rst day of the academic year?
Yes
No
if yes, you are an independent student, go to section 6
a
2 Have you been married or in a civil partnership at any time before the rst
day of the academic year?
Yes
No
if yes, you are an independent student, go to section 6
a
3 Will you have the care of a person under the age of 18 on the rst day of the
academic year?
Yes
No
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
nancially for a total of 3 years or more before the start of the rst 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.
n
the
For any three month period ending after your 16th birthday and before the rst day of
rst academic year of your course you have been in the custody of, in legal care of,
or have been given accommodation by a local authority but you have not been under
the legal care of your parents.
n
Both your parents are deceased.
Your parents are living outside the UK, Gibraltar or EU and the assessment of their
nancial circumstances would place them in jeopardy.
You have applied for student nance before, and the parent who provided their income
details is deceased.
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 have ticked any of the boxes above, you will be contacted for evidence and
subject to this, you may be considered independent.
13
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
Estimate the total taxable unearned income, before deductions,
that you expect to receive in academic year 2021/22.
What is the source of this income?
Payments from an employer
b1 Will your employer be releasing you to attend your course
for the academic year?
Yes
No
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 the academic year, will you or your employer
pay any money into a pension fund on your behalf?
Yes
No
If ‘Yes’, how much during this period?
Dependent children
c Give details of any children who will be wholly or mainly nancially dependent on you during
the academic year.
Your child’s income includes their income from all sources after income tax and National
Insurance contributions in the 2019-20 tax year.
Child’s full name
Date of
birth
(DD MM YYYY)
Relationship
to you
Who will they
live with?
Child’s income
£
£
£
14
Section 7
Special Support
Tick any of the boxes below that are relevant to you. You must send supporting evidence
with your application. Read the notes to nd out what evidence to send.
I’m a lone parent or lone foster parent with a child or young person under 20 who is
in full-time education below higher education level or on an approved training course
I have a partner who is also a student, and one or both of us are responsible
for a child or young person under 20 who is in full-time education below higher
education level or on an approved training course
I have a disability and qualify for the Disability Premium or Severe Disability
Premium
I’m deaf and qualify for Disabled Students’ Allowance
I have been treated as incapable of work for a continuous period of at least 28 weeks
I have a disability and qualify for income-related Employment and Support Allowance
I’m waiting to go back to a course having taken agreed time out from that course
due to an illness or caring responsibility that has now ended
I’m entitled to Personal Independence Payment (PIP)
I’m entitled to Disability Living Allowance (DLA)
I’m entitled to Armed Forces Independence Payment (AFIP)
None of the above
15
Section 8
Parents’ Learning Allowance, Childcare
Grant and Adult Dependants’ Grant
Only complete this section if you want to apply for 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?
Yes
No
if no go to c1
b Give the total estimated income after income tax and National Insurance deductions in the
academic year for:
You Your partner
How much of this will be Child Tax Credit or the childcare element of Universal Credit for
the academic year?
You Your partner
c1 Do you want to apply for Childcare grant?
Yes
No
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 NHS.
Yes
No
If ‘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
Child 1
Forename(s)
Surname
Date of birth
Day Month Year
Child 2
Forename(s)
Surname
Date of birth
Day Month Year
If you need more space for additional children, give the
details above on the additional notes at the back of this form.
£
£ £
£
16
Section 8
Parents’ Learning Allowance, Childcare
Grant and Adult Dependants’ Grant - continued
d1 Are you applying for Adult Dependants’ Grant?
Yes
No
if no go to
section 9
d2
husband,
wife,
civil partner or
partner (if you are over 25)
go to
section 9
other adult dependant
d3
Will your ‘other adult dependant’s’ income be more than
£3,796 in the academic year?
Yes
No
if no go to
section 9
If ‘Yes’ you will not be able to apply for Adult Dependants’ Grant
d4
Who is your adult dependant?
Give your adult dependant’s income for the 2019-20 tax year.
Total gross income
All salary/wages and self-employed income
(include income from property)
All pensions (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 and interest from
savings, investments and dividends
Taxable state benets
All other taxable income
Deductions
Private pension contributions and Additional
Voluntary Contributions (AVCs)
Allowable expenses on which tax relief is
claimed
£
£
£
£
£
£
£
17
e
Section 9
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 18 and 19 and then pass this form to your partner to complete section 10.
If you are a single independent student, go to the terms and conditions on pages
18 and 19.
a With which parent do you normally live, or have more contact with?
Mother Father
b What is the current relationship status of
this parent?
Single
Living with a partner
Married/civil partnership
Separated
Divorced/dissolved civil partnership
Widowed/surviving civil partner
c
Have your parents divorced, separated,
been in a civil partnership which has been
dissolved, or been widowed since
1 September 2020?
Yes
No
or
Both parents N/A
What you need to do next
Read and sign the terms and
conditions on pages 18 and 19 and
then pass this form to your parent(s).
What your parent(s) need to
do next
The parent(s) you normally live with
should complete section 10.
If the parent indicated in ‘a’ is
married, in a civil partnership or living
with a partner, their partner must
also complete section 10
.
Terms and Conditions
These terms and conditions (“terms”) and applicable
legislation apply to all of the student nance
available to students for the academic year 2021/22.
I understand that I must read the specic terms
about the student nance products available
because they will aect me if I apply for them at any
time in this academic year.
I understand that my application for student nance
may be delayed unless I sign and date these terms.
Loan Contract
1. I conrm I have read and understood these
terms and A Guide to Terms and Conditions
available at www.gov.uk/studentfinance
2. I conrm 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 nance, any support
I have had may be withdrawn and I could be
prosecuted.
3. I understand that student nance is provided
to me by the Secretary of State for Education
(the “Lender”) which includes any persons
acting on his/her behalf and any replacement(s)
under section 23(4) of the Teaching and Higher
Education Act 1998 as amended or replaced
from time to time (the “Act”).
4. I understand these terms, the Act and the
regulations made under section 22 of the Act
will apply to any student nance provided to me
by the Lender.
5. I understand that “student nance” in these
terms means nancial 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”) carries 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 section 22 of the Act before I reached
the age of 18 years,
18
I am agreeing to “ratify” any and all such
student loans by signing these terms.
This means that I conrm 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 nance under the regulations.
8. I agree to give SLC any information they need
in support of this application for student nance
and to seek repayment.
9. I agree to tell SLC immediately if my
circumstances change in any way that might
aect my entitlement to student nance. I
understand that if I do not do this I may not get
any further payments and I may have to repay
the student nance I have already received. I
agree that from the date I submit my student
nance application until my loan(s), together
with all and any interest, penalties and charges
which apply, is fully repaid I must tell SLC 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
nance, I need to repay this in full and that any
overpayment may be taken from any future
entitlement to student nance.
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 Act 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.
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 rst 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.
SFE/PR1F/2122
19
Legal Action and Applicable Law
Childcare Grant (“CCG”)
14. In the event of any legal action, I agree that the
laws of England and Wales 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.
This section applies if I apply for CCG this academic
year.
Sharing Information
15. If I am in breach of these terms and/or the
regulations I agree that the Lender may share
22.
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 conrm where I have provided any personal
information about any other person in my student
nance 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.sfengland.slc.co.uk/privacy-notice
which may be updated from time to time.
Disabled Students’ Allowance (“DSA”)
This section applies if I apply for DSA this academic
year.
18. I understand that any equipment I receive
through DSA 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 notied if SLC will make
payments directly to suppliers on my behalf.
20. I understand and agree that in order to receive
any CCG, SLC may share my personal details
and my children’s details with a contracted third
party who will be handling the administration of
CCG on behalf of SLC.
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.
I conrm 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; and/or
iv. the NHS Bursary 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 may share my personal data with HMRC to
check whether I get childcare support.
Customer Reference Number
Your full name
(in BLOCK CAPITALS)
Day Month Year
Today’s
Your signature
(in ink)
x
date
The relevant person(s) you indicated in section 9 must complete section 10, as well as the
declaration(s) on page 28. Please pass this form to them now.
If you are a single independent student please now go to page 32.
20
Section 10
Financial details for tax year 2019-20
for parents and partners
Who needs to complete this section?
Section 9 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 nancial 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/are entitled to.
About this section
Section 10 is split into five parts:
Part A - Tell us your name and address and some other personal information
Parts B - Tell us your National Insurance number
Parts C and D - Answer every question
Part E - Answer every question and tell us about any income deductions for tax year
2019-20 where appropriate
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 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 15 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 15% or more since tax year 2019-20 you can apply
for a Current Year Income (CYI) 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 15% 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.
Before completing this form, you should read the Privacy Notice on page 22 of the
accompanying notes.
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 nancial details with them.
For more information about this, read our Privacy Notice.
21
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/
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Section 10
Financial 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 certicate 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 certicate or passport)
Home address
Postcode
Home telephone number
Email address
You do not have to disclose your nancial information to the student.
If you would like to provide your nancial information separately, you can download a form at
www.gov.uk/studentfinance or alternatively, you can have the form sent to you by ticking the box below:
Person 1
Send me a separate form
Person 2
Send me a separate form
22
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-
-
Section 10
Financial details for tax year 2019-20
for parents and partners - continued
Part B - Data sharing and you
We will share and check the details you give us with HM Revenue & Customs, allowing us to
gain the most accurate information possible. This can only be done if you have a valid National
Insurance (NI) number.
Person 1
I have an NI number
Please provide your NI number below:
You are now ready to
provide your nancial
information.
go to Part C
Person 2
I have an NI number
Please provide your NI number below:
You are now ready to
provide your nancial
information.
go to Part C
I do not have an NI number
If you do not have an NI number
because you receive non-UK
taxable income, please provide the
equivalent nancial information in
pounds sterling.
You are now ready to
provide your nancial
information.
go to Part C
I do not have an NI number
If you do not have an NI number
because you receive non-UK
taxable income, please provide the
equivalent nancial information in
pounds sterling.
You are now ready to
provide your nancial
information.
go to Part C
23
Section 10
Financial details for tax year 2019-20
for parents and partners - continued
Part C - Your financial information
Instructions
Please give gross nancial details for the tax year from 6 April 2019 to 5 April 2020.
Answer ‘Yes’ or ‘No’ to every question, if you answer ‘Yes’ please provide the income amount.
If any questions are left blank we will not be able to process this application.
You do not need to send us any evidence. However, you should keep all of your 2019-20
nancial evidence as we may ask for it at a later date to verify the details you have provided.
Q1
Did you receive any income from salary, wages,
taxable state benets or from occupational or private
pensions?
Person 1
Yes No
a Total income from salary/wages
b Total income from taxable state benets
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.
Q2 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
Q3 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
Person 2
Yes No
24
Section 10
Financial details for tax year 2019-20
for parents and partners - continued
Q4
Did you receive any taxable benets in kind?
Person 1
Yes No
Person 2
Yes No
Total income received from taxable benets in kind
Q5 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 D
No
go to Part E
Person 2
Yes
go to Part D
No
go to Part E
Part D - Other income
Instructions
Complete Part D in the same way you completed Part C giving gross nancial details for the tax
year from 6 April 2019 to 5 April 2020.
Q1
Did you receive any income from self-employment?
Person 1
Yes No
Person 2
Yes No
a
Total adjusted prot from businesses
b
Total adjusted prot from partnerships
Q2
Did you receive any income as a Minister of religion?
Yes No Yes No
Total taxable income minus expenses that are not
included on your P60 or P11D
£
£
£
£
£ £
£
25
n
n
Section 10
Financial details for tax year 2019-20
for parents and partners - continued
Q3
Did you receive any other taxable income or
lump sums?
Person 1
Yes No
Person 2
Yes No
Total income received
Q4
Did you receive any income from property lettings?
Yes No Yes No
Total income received
Q5
Did you receive any income from UK trusts?
Yes No Yes No
Total income received
Q6 Did you receive any foreign income?
Yes No Yes No
Total income received
Q7
Did you receive any taxable income from an overseas
pension?
Yes No Yes No
Total income received
Q8
Did you receive any other overseas income
and gains?
Yes No Yes No
Total income received
n
n
n
n
£
£
£
£
£
£
£
£
£
£
£
£
n
26
n
Section 10
Financial details for tax year 2019-20
for parents and partners - continued
Part E – Income deductions
Instructions
Complete Part E in the same way you completed Part C giving gross nancial details for the tax
year from 6 April 2019 to 5 April 2020.
Q1
Did you pay any private pension contributions?
Person 1
Yes No
Person 2
Yes No
Total amount you paid
Q2
Did you pay any Additional Voluntary Contributions
(AVCs)?
Yes No Yes No
Total amount you paid
Q3
Did you have any allowable expenses on which
you claimed tax relief?
Yes No Yes No
Total amount on which you claimed tax relief
£
£
£
£
£
£
n
27
Section 10
Financial details for tax year 2019-20
for parents and partners - continued
Part F – Your dependants
n
Identify any children who will be wholly or mainly nancially dependent on you.
Q1 Child dependants not in further or higher education in academic year 2021/22
n
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
Day Month Year
Income for the year
Full name
Date of birth
Day Month Year
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 8 of this form if the
children have applied for student nance.
Full name
Date of birth
Day Month Year
School, college or university
Course
Are they receiving nancial support? If so, from
which authority or organisation?
Do you want to support this student’s
application for student nance?
Yes No
Full name
Date of birth
Day Month Year
School, college or university
Course
Are they receiving nancial support? If so, from
which authority or organisation?
Do you want to support this student’s
application for student nance?
Yes No
28
SFE/PR1F/2122
Declaration for parents and partners
This application for financial support may be delayed unless you sign and date this
declaration.
I conrm 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(s) I am supporting may not recieve
nancial support, any support they have had may be withdrawn and I could be prosecuted.
I agree to supply any further information in relation to the applicant’s application for nancial
support that the Student Loans Company Ltd (SLC) may ask for and agree to tell them
immediately if my circumstances change in any way that might affect this application for
nancial support.
Person 1
Your full name (in BLOCK CAPITALS)
Your signature (in ink)
Today’s date
Day Month Year
Person 2
Your full name (in BLOCK CAPITALS)
Your signature (in ink)
Today’s date
Day Month Year
Deadline
To make sure the student receives their rst 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 the application as soon as possible, however if the deadline date
has passed, the rst payment may not be ready for the start of term.
Now pass this form back to the student.
29
Additional notes
If you are providing extra information please clearly mark what section and question the
information is about.
30
Additional notes
If you are providing extra information please clearly mark what section and question the
information is about.
31
Additional notes
If you are providing extra information please clearly mark what section and question the
information is about.
32
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’ve asked for as evidence where you’ve seen this
icon next to a question
Signed and dated the terms and conditions on pages 18 and 19
Checked your parent(s) or partner have signed their declaration on page 28
(if applicable)
What happens next
It can take at least 6 weeks to assess your application and all the relevant evidence.
We’ll then send you a letter showing the amount of nancial support you’ll receive.
Please remember to pay the correct postage.
We cannot accept this application form if it is uploaded to your online student
finance account.
You must return your completed form to the address shown below:
Student Finance England
PO Box 210
Darlington
DL1 9HJ