Budgeting Loans from the Social Fund Form
About you and your partner
Part 1
For office use only
Application number
Date of SFCS input
/ /
Date decision made
/ /
Initials
Signature
1
SF500 04/05
l
Before you complete this form, please read the notes sheet which
tells you about all types of help you can get from the Social Fund.
l
Use this form to apply for a
Budgeting Loan
. Complete this form in
ink, sign and date any alterations you make.
l If you are getting Income Support, income-based Jobseeker’s Allowance
or Pension Credit, the person who both claims and gets paid that benefit
or entitlement should fill in this form.
You Your partner
Surname or family
name
Other surnames you
have been known by
National Insurance (NI)
number
Letters Numbers Letter Letters Numbers Letter
Mr / Mrs / Miss / Ms
All other names in full
Mr / Mrs / Miss / Ms
You can find the number on your National Insurance
(NI) numbercard, letters about your benefit or payslips
You can find the number on their National Insurance
(NI) numbercard, letters about their benefit or payslips
Address where you
live now
Tell us your partner’s
address, if different
Postcode Postcode
/ / / /
What is this number?
Please tick
Code Number Code Number
workHome mobile fax faxworkHome mobile
Are you or your partner
involved in a trade dispute?
We use trade dispute to mean
a strike, walk-out, lock-out or
any other dispute about work.
No
Yes
No
Yes
l
Tell us about yourself and your partner, if you have one.
We use partner to mean a person you are married to or a person
you live with as if you are married to them.
l
Fill in the form fully by answering all the questions and requests for
information. Your application may be delayed if we do not have
all the information we need.
Date of birth
Daytime phone number
Budgeting
Loans
from the
Social Fund
Page 3/16
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Budgeting Loans from the Social Fund Form PDF
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