If you do not know your National Insurance number,
have you e ver had one or used one at any time?
Y es Please tell us the Child Bene fit number we gave you
ou can f
ind this on let
ters we have sent you. If you cannot
find the number do not delay sending this form back to us.
Y es Please tell us the ful l name of the eldest child you are
getting Child Benefit for
What is this child’ s date of birth?
D D M M Y Y
C H B
D D M M Y Y
National Insurance number.
tes, page 9
Title, enter MRS, MISS, MS, MR or other title
Surname or f amily name
All other surnames or f amily names you have
been known by . Please include maiden name,
all former married names and al l changes of
f amily name.
Date of birth
Address (including postcode)
If you, or your par
tner if you ha
, are a
Crown Servant working abr oad, enter one of
the fol lowing
• your full BFPO addres s or
• an address care of a member of HM Armed
Forc es unit or
or civil ser
ants, your emplo
department’ s address.
e you ever claimed Child Benefit before?
If you are still getting Child Benefit, tick Y es.
Are you getting any Child Benefit now?
lease re ad the notes that came with this form bef ore you fill it in.
They will give you mor e information about Child Benefit and help you to fill in this claim form.
Please make sure you
• answer all the questions on this form that appl y to you, and your partner if you have one
• give us details of an account into which we can pay your Child Benefit
• send us all the documents we ask f or.
If you do not, it may take longer to pay you Child Benefit, or we may not be able to pay you at all.
P ART 1 PERSONAL DET AILS
Child Benefit claim