e-form

Children in Care Allowance - Residential Service

Details of Residential Service from where claim is being made

Name of Residence

Mobile Number

Contact Number

E-mail

Door Name

Door Number

Building Entry Point Name

Street Name

Locality Name

Post Code

Details of Head of Residential Service

Name

Surname

ID Card No

Details of Children about whom claim is being made

Name

Surname

Date of Birth (DD/MM/YYYY)

Is child under a Care Order?

Service Started Being Used On (DD/MM/YYYY)

Name

Surname

Date of Birth (DD/MM/YYYY)

Is child under a Care Order?

Service Started Being Used On (DD/MM/YYYY)

Name

Surname

Is child under a Care Order?

Date of Birth (DD/MM/YYYY)

Service Started Being Used On (DD/MM/YYYY)

Name

Surname

Is child under a Care Order?

Date of Birth (DD/MM/YYYY)

Service Started Being Used On (DD/MM/YYYY)

Bank Account Details

* Bank Name

* IBAN

Enter Mobile Number for an SMS notification regarding payment

Benefit should be deposited in a Savings or Current Account, but not a Loan Account.

Necessary Documents
Tick which documents are to be attached
* Indicates a mandatory document

IMPORTANT: So as not to have the benefit forfeited, claim should be received by the Department of Social Security within six (6) months from when the child started living within the Residential Service.