Carers Allowance Claim Form
6
About the care you provide
Their date of birth
Their address
You do not have to live at
the same address as the
person you look after.
Their daytime phone
number, including dialling
code. We will not give this
number to anyone else.
Title, for example
Mr, Mrs, Miss, Ms.
Their surname or family
name
Please tell us about the person you look after.
This will help us deal with your claim more quickly.
Their other names in full
Their National Insurance
(NI) number
/ /
Day Month Year
What relation is this person
to you?
If no relation, write None.
You can get this from their NI number card, letters about
benefits, payslips or form P60.
Children aged 16 and under have NI numbers. The child’s NI
number is the reference number on letters about Disability
Living Allowance for the child.
Postcode
Letters Numbers Letter
No
Yes
Does the person you look
after get Armed Forces
Independence Payment?
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