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
Mothers 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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Child Benefit Claim Form PDF

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