Child Benefit Claim Form
Page 6
Are you planning to adopt any of the
children?
If any of the childr en you want to claim for
• are not your own, and
• you are not planning to adopt them
please tell us
• the child’ s name,
• any pre vious surname (if you know it)
• the mother’ s name (if you know it)
• the f ather’ s name (if you know it)
This will help us deal with your claim more
quickly.
P ART 4 CHILDREN THA T ARE NO T YOUR OWN
No
Y
es If yes, please tell us the names o f the children you plan to adopt
a
nd then go to
P
P
a
a
r
r
t
t
5
5
,
,
p
p
a
a
g
g
e
e
7
7
Child’ s name
Pre vious surnames
Mother’ s name
Father’ s name
Child’s name
Pre vious surnames
Mother’s name
Father’ s name
Child’ s name
Pre vious surnames
Mother’ s name
Father’ s name
Child’ s name
Pre vious surnames
Mother’ s name
Father’ s name
Page 6/12
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