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BCON / NINEDAY
              CICS Account and case numbers: 55508596 01623514





             2.
               Did / do you or your partner receive any other                   Yes            No
               income or benefits, such as state retirement

               pension, tax credits or incapacity benefit?

               If Yes, please list them below and provide proof


                                                                                £


                                                                                £


                                                                                £


              Have you applied for Working Tax Credit? Yes                                        No



              If Yes, when did you apply








                    3

                Have you/your partner reapplied for


                Income Support                                                  YES            NO

                Job Seekers Allowance                                           YES            NO

             If YES, when did you reapply





             If you have reapplied for benefit, it may not be continuous from the date
             that your previous entitlement ended. Therefore, we will not be able to
             pay you more benefit unless we have proof of your income
             during these periods.











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