Fillable PTGFD 2020/21 Grants for Dependants application form for (London Institute of Management and Technology)

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PTGFD 2020/21 Grants for Dependants application form for (London Institute of Management and Technology)

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SFW/PTGFD/2021/A
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2020/21
PTGFD
Grants for Dependants application form for
part-time students
About this form
Who should complete this form?
You should complete this form if:
• you’re living in Wales
• you want to apply for Parents’ Learning
Allowance, Adult Dependants’ Grant and/or
Childcare Grant
• you’re a part-time student studying an
eligible course
• you’ve already applied for part-time loans
and/or grants for academic year 2020/21
How to use this form
• Check your personal details then complete all of the questions that apply to you in section 2.
i
Where you see this icon we’ve provided extra guidance to help you answer the question.
e
Where you see this icon you need to send us documents to support your application.
• Read, sign and date the declaration in section 3 and return your form to us along with any
documents we’ve asked for.
• Read section 4 to nd out if your university or college need to do anything.
To nd out how we’ll use the information you provide go to
www.studentnancewales.co.uk/privacynotice to read our Privacy Notice before
completing this form.
SFW/PTGFD/20212 of 8
-
-
£ £
1
Your personal details
Customer Reference Number
Forename(s)
Surname
Home address
Postcode
Date of birth
Day Month Year
2
Parents’ Learning Allowance, Adult Dependants’ Grant and Childcare Grant
2.1 Are you a lone parent?
No
Yes – go to 2.4
2.2 Are you under 25, living with a
partner and applying for a Childcare
Grant or Parents’ Learning
Allowance?
No – go to 2.4
Yes
2.3 Total (estimated) income after
Income Tax and National Insurance
contributions have been deducted
for academic year 2020/21
This information will be used to work out if
your children are mainly nancially dependent
on you or your partner during academic year
2020/21.
You
Your partner
SFW/PTGFD/2021
3 of 8
2.3.1 How much of this will be Child Tax
Credit or the child element of
Universal Credit for academic year
2020/21?
You
Your partner
£ £
If you are not applying for Childcare Grant
go straight to 2.5
2.4 During the 2020/21 academic year,
do you or your spouse, civil partner
or cohabiting partner receive, or
expect to receive:
• the childcare element of Working
Tax Credit or Universal Credit; or
• Tax-Free Childcare from HMRC; or
• Childcare Allowance from the
National Health Service (NHS)?
Parents’ Learning Allowance, Adult Dependants’ Grant and Childcare Grant – continued
2
No
Yes – You can’t get Childcare Grant if you
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.
If you apply for Childcare Grant or you choose to receive Childcare Grant instead of the
childcare element of either Working Tax Credit or Universal Credit, Tax-Free Childcare from
HMRC or a Childcare Allowance from the NHS you will be sent a separate form (PTCCG1) to
tell us your estimated childcare costs.
i
2.5 Are you applying for Adult
Dependants’ Grant?
No – go to 2.7
Yes – Who is your adult dependant?
husband, wife, civil partner – go to 2.7
partner (if you are 25 or over) – go to 2.7
other adult dependant
2.6 Will your other adult dependant’s
income be more than £3,923 for
academic year 2020/21?
No – go to 2.8
Yes – You can’t get Adult Dependants’ Grant
2.7 Did you start your course on or after
1 August 2018?
No – go to 2.8
Yes – go to section 3
SFW/PTGFD/20214 of 8
i
Parents’ Learning Allowance, Adult Dependants’ Grant and Childcare Grant – continued
2
2.8 Give your husband, wife, civil
partner, partner or other adult
dependant’s income for tax year
2018-19
e
£
£
£
£
£
£
£ £
£ £
£ £
£
£
Note: All boxes must be completed with £0 or
N/A, don’t leave them blank.
You need to send copies of documents that
show any taxable income received. For
example: P60, month 12/ week 53 payslip, or
employer’s letter to conrm earnings.
Income
Husband, wife, civil
partner or partner
Other adult
dependant
All salary, wages and self employed
income (including 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
For example, money received as compensation
or from redundancy. You must include the full
amount of your redundancy payment, even if
you don’t expect to pay tax on it.
Deductions
Private pension contributions and
Additional Voluntary Contributions
(AVCs)
Allowable expenses on which tax relief
is claimed
If your husband, wife, civil partner, partner or other adult dependant’s income will be at least
£1,000 less in tax year 2020-21 than it was in tax year 2018-19 you can apply for a current year
income assessment. This means we would use their expected income for tax year 2020-21
instead of their actual income for 2018-19 when working out your grant entitlement. If you want
to be assessed using expected income for tax year 2020-21 attach a separate piece of paper to
your application to let us know.
You still need to complete this section with your husband, wife, civil partner, partner or
other adult dependant’s income for tax year 2018-19.
If you tell us you want to apply for a current year income assessment we’ll send you another
form to complete.
SFW/PTGFD/2021
5 of 8
Parents’ Learning Allowance, Adult Dependants’ Grant and Childcare Grant – continued
2
£
£
£
£
£
£
•
x
Only complete this question if you started your course before 1 August 2018
2.9 Give details of nancial
commitments you have before the
start of your course which you, your
husband, wife or partner will
continue to pay for during academic
year 2020/21.
e
Financial commitments to include would be
insurance policies such as household or
medical insurance, life assurance premiums,
mortgage repayments or maintenance
payments for a dependant. You’ll have to
send documents showing any nancial
commitments you tell us about on this form.
Type Annual Amount
3
Student declaration
Declaration
If you cannot sign the form it must be signed on your behalf by your attorney. The Power of
Attorney letter must be sent with the application before a signature from that attorney will be
accepted.
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 I may not receive nancial support, any support I have had may
be withdrawn and I could be prosecuted. Any information provided which is found to be materially
inaccurate may be regarded as evidence of an attempt to mislead the Student Loans Company
Ltd (SLC). In such circumstances, SLC may report the matter to the authorities and/or terminate
your eligibility for student nance.
Your full name
(in BLOCK CAPITALS)
Your signature
Today’s date
Day Month Year
Once your form is fully complete and the declaration has been signed and dated,
you should return it to: Student Finance Wales,
PO Box 211,
Llandudno Junction,
LL30 9FU
University or college
information
6 of 8
We need information from your university or college to work out how much grant you
can get.
If you started your course on or after 1 August 2018, your university or
college don’t need to complete this section.
What you need to do
1) Check your personal details and complete your course details in this section
2) Take this to your university or college to complete the rest of the section
3) Return your completed application form to us.
If you have already taken this section to your university or college as part of
an application for part-time grants, you won’t need to do this again.
What your university or college need to do
They need to complete the university or college information section to conrm your
course details and course intensity.
They only need to complete this section once.
What if my university can’t complete this section right now?
If you’re applying early, your university or college may not be able to complete this
section yet. Don’t worry, you can still apply early.
All you need to do is tear out this section and keep it until your university or college
can complete it at a later time. In the meantime, send us the rest of your completed
application form so we can start to process it.
Later, once your university or college completes section 4, post it to us and we will
complete your assessment and write to you to tell you what you can get.
- -
SFW/PTGFD/2021
4
University or college information
7 of 8
Student’s details
You need to check and complete the details below before passing this section to your university or college.
Customer Reference Number
Your name
Your date of birth
Day Month Year
Course name
Qualication you expect to gain
Now pass this section to your university or college to complete.
University or college information
Complete the details below then pass this section back to the student. To nd out how we’ll use the
information you provide go to www.studentnancewales.co.uk/privacynotice to read our Privacy Notice
before completing this form.
Course fee charged to this student
for 2020/21
Course start date
£
- -
Day Month Year
- -
Course end date
Day Month Year
SLC or UCAS university/college code
I conrm to the best of my knowledge and belief:
• the student intends to complete the following number of credits, credit points, modules or any other
unit of measure by studying on a part-time basis in academic year 2020/21
• the following number of credits, credit points, modules or any other unit of measure would comprise
the equivalent full-time course within one academic year for new students, or the duration of the
course for continuing students
• it’s possible for the student to complete the course in no more than twice the length of time required
to complete the equivalent full-time course
• the student’s course is designated as eligible for nancial support under Regulation 90 of the
Education (Student Support) (Wales) Regulations 2018.
• the equivalent full-time course would last
Years
Part-time units
Enter number of units
Unit of measure
(select applicable)
Full-time units
Enter number of units
Student’s course
intensity is
credits modules other
credit points
÷ x 100 =
University or college information – continued
Your full name (in BLOCK CAPITALS)
-
-
Your position
Your phone number (including area code)
Your email address
Your signature
x
SFW/PTGFD/2021
8 of 8
4
Today’s date
Day Month Year
University or college stamp
Once your form is fully complete and the declaration has been signed and dated, you should return it to
the address on the covering letter sent with the form.
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PTGFD 202021 Grants for Dependants application form for (London Institute of Management and Technology)

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Completed 4 July 2021

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