Child Benefit Claim Form

Page 3
If you hav e a partner, read the notes on pages 11 and 17 to 21 to help you decide who shoul d claim Child Benefit.
They tell you about pr otecting your Basic State Pension if you give up work to care for a child you get Child Benefit for.
P ART 2 P ARTNER’S DET AILS
Do you have a partner?
Is your partner a United Kingdom national?
See notes, page 9
Is your partner
already getting, or
waiting to hear if they can get
Child Benefit for any childr en?
Y our partner’ s name (in full)
Y our partner’ s National Insurance number
Y our partner’ s Child Benefit number
Full name of the
eldest child your partner
gets Child Benefit for (or is w aiting to hear
about Child Benefit for)
See notes, page 4
What is this child’ s date of birth?
No
G
G
o
o
t
t
o
o
P
P
a
a
r
r
t
t
3
3
Y
es Please answer the questions below
N
o If no , please tell us your partner’ s nationality
Yes
No
G
G
o
o
t
t
o
o
P
P
a
a
r
r
t
t
3
3
Yes
Give details below
D D M M Y Y
C H B
P ART 3 CHILDREN YOU W AN T TO CLAIM FOR
Please tell us about the childr en you want to claim for now . Do not tell us about any children you already get
Child Benefit for.
Please enter the name exactly as shown on the child’ s birth or adoption certificate.
If you want to claim for more than 4 childr en, use the space in P art 6 to tell us about them.
1
st CHILD
Surname
Other name(s)
Se
x
Date of birth
Male
F
emale
D D M M Y Y
F
or o
ffice
use 3
For office
use 4
2
nd
CHILD
Surname
O
ther name(s)
Sex
Date of birth
Male Female
D D M M Y Y
Page 3/12
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Child Benefit Claim Form PDF

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