LCTS Working Age Change of Circumstances Form

Title

First name

*

Last name

*

Date of birth

*

Gender

National Insurance Number

*

Address search

Phone number

*

Email Address

**

Council Tax reference number (8 digits, found on your Council Tax Bill)

*

Are you a full-time Student?

YesNo

Do you have a partner who lives with you?

YesNo

Do you have any Children who live with you whom you receive Child Benefit for?

YesNo

Do you have any other adults who live with you who are over the age of 18 and you do not receive Child Benefit for?

YesNo

Form completion reason