Funeral Payment claim form

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Text of Funeral Payment claim form

  • Social Fund Funeral ExpensesPayment for an adult

    SF200adult 04/18

    About this forml Use this form to claim a Funeral Expenses Payment for an adult. But remember,

    the easiest way to claim is by calling 0800 731 0469. l This form and the notes are available in Welsh.l Before you fill in the claim form, please take a few minutes to read the notes

    that came with this form. They contain important information and help explainsome of the questions we ask you and why we are asking them.

    l Fill in this form with BLACK INK and in CAPITALS.l We are sorry if some of the questions in the form upset you. But, if you answer

    all the questions as fully as possible, and send us all the documents we haveasked for, including a final funeral bill or contract, youwill help us decide quicklyif you can get a Funeral Expenses Payment or not.

    l If you have difficulty filling in this form, dont be worried about asking for help.You can ask a relative, friend or someone at an advice centre to help youbutyou must sign the form yourself.

    l You must claim a Funeral Expenses Payment within 6 months of the date of thefuneral. If you are waiting for a decision on a qualifying benefit, you must stillclaim within the time limit.

    Money belonging to the person who has died can sometimes be released to payfor the funeral if you apply for it. This can even apply before probate or letters ofadministration or, in Scotland, confirmation, have beengranted.You can get more information at www.gov.uk

    Important InformationThe easiest way to claim a Funeral Expenses Payment is by phone.Call 0800 731 0469 and choose option 2.The lines are open from 8am to 6pm Monday to Friday,exceptpublic holidays.Calls to 0800 are free from landlines and mobiles.

    By adult we mean:Someone aged 20 or over, or someone aged 16 to 19 who is not in full-time,non-advanced education or training.For all other circumstances please use the form Social Fund FuneralExpenses Payment for a child.

  • 2

    Part 1: About you and your partner

    Do you have a partner?We use partner to meanl a person you live with who is your

    husband, wife or civil partner, orl a person you live with as if you

    are a married couple.

    YesNo Tell us your details below.

    Tell us about you and your partner below.

    If your partner is the person who has died do not complete theirdetails in the partner section below but tell us about them in Part 2.

    You Your partner

    National Insurance (NI) numberYou can find the number on aNational Insurance (NI) numbercard,letters about benefit, or payslips.

    If you do not know your NationalInsurance number, have you everhad one or used one at any time? Yes

    No

    Yes

    No

    Letters Numbers Letter Letters Numbers Letter

    Surname or family name Mr / Mrs / Miss / Ms Mr / Mrs / Miss / Ms

    All other names, in full

    Date of birth / / / /

    Daytime phone number, if you have one.

    Mobile phone number if you have one.If you have a mobile phone we will textyou to let you know that we have gotyour claim.

    Current addressPlease tell us your current address, andtell us your partners current address,ifits different.

    Postcode Postcode

    We may need to contact you by phone toget more information or to let you knowwhen we have made a decision on yourclaim. Please note that our number mayshow as 0800, unknown or withheld.

    SF200adult 04/18

    Email, if you have one.

  • 3

    Part 2: About the person who has died

    Mr/Mrs/Miss/MsTheir surname or family name

    Their other names, in full

    Their National Insurance (NI) number

    Letters Numbers Letter

    Their address

    Postcode

    Will the funeral take place in theUnited Kingdom (UK)?The UK is England, Scotland, Walesand Northern Ireland.

    Yes

    No

    Did the person who has died havetheir main home in the UK? Yes

    No We will contact you about this.

    Their date of birth / /

    The date they died / /

    The date of funeral if known / /

    If the funeral is not in the UK, inwhich country will it take place?Please see the notes booklet. If thefuneral is not in one of the countriesshown, you cannot get help.

    SF200adult 04/18

  • Part 3: About paying for the funeral

    4

    Have you or your partner takenresponsibility for the funeralexpenses?

    Is the bill for the funeral in yourname or your partners name?

    Yes

    No You will not be able to get a Funeral Expenses Payment.

    Yes

    No

    If you ticked No, please say why you areresponsible for paying the bill.For example, someone may have madethe arrangements on your behalfbecause you were ill.

    Has anyone else claimed a FuneralExpenses Payment for this person? Yes

    No

    Mr / Mrs / Miss / Ms

    Their date of birth / /

    Their NI number

    Letters Numbers Letter

    Their address

    Postcode

    Please tell us about them.

    Their full name

    Please tell us why they have claimeda Funeral Expenses Payment forthisperson?

    SF200adult 04/18

  • Part 4: About benefits

    5

    Are you or your partner getting any ofthe following:l Universal Creditl Income Supportl income-based Jobseekers Allowancel income-related Employment and

    Support Allowancel Pension Creditl The disability or severe disability

    element of Working Tax Creditl Child Tax Creditl Housing Benefitl Support for Mortgage Interest

    Yes

    No

    Are you or your partner waiting to hearabout a claim for any of the following:l Universal Creditl Income Supportl income-based Jobseekers Allowancel income-related Employment and

    Support Allowancel Pension Creditl The disability or severe disability

    element of Working Tax Creditl Child Tax Creditl Housing Benefitl Support for Mortgage Interest

    Yes

    No

    If you or your partner are waiting to hear about a claim forHousing Benefit, do not wait until you hear about the claim.Send this form to us. You will get a letter from the council to tell you if you can getHousing Benefit. Send this letter to us as soon as you can.

    Please tell us which benefits you are getting

    Please tell us which benefits you are waiting to hear about.

    Now go to Part 5.

    If you or your partner are getting Housing Benefit, send us the latestletter from the council which tells you that you are entitled to HousingBenefit. Send it with this form.

    SF200adult 04/18

    If you or your partner are not getting, or waiting to hear about a claim for any of the above benefits, you will not be able to get a Funeral Expenses Payment.

  • 6

    Part 5: About taking responsibility for the funeral

    Was the person who died yourpartner who you were living with atthe time of their death, or you hadbeen living with immediately beforeone or both of you moved into a carehome?We use partner to meanl a person you live with who is your

    husband, wife or civil partner, orl a person you live with as if you are a

    married couple.

    YesNo

    Please go to Part 6.

    Is there a surviving partner of theperson who has died? Yes

    NoPlease tell us about them.

    Their full name

    Please tell us why this person is notclaiming the Funeral ExpensesPayment.

    Mr / Mrs / Miss / Ms

    Their address

    Postcode

    Please tell us their relationship to you For example, they were your son,daughter, sister, brother,daughter-in-law, father-in-law,step-parent, step-son,step-daughter-in-law, close friend.

    SF200adult 04/18

    Did the person who has died have anyother surviving parents or children?Do not include yourself or any childrenof the person who has died if ChildBenefit is still in payment for them.

    YesNo Please go to page 12.

  • Part 5: About taking responsibility for the funeral continued

    Please tell us about the other surviving parents or children onpages 8 and 9. If you need more space, please use a separatesheet of paper. Remember to put your full name and NI numberon any separate sheet of paper you use.

    Yes

    No

    Please tell us their full names.

    Had the relationship between theperson who has died and any ofthe surviving parents or childrenbroken down?

    Please tell us how the family relationshiphad broken down, and for how long.

    7SF200adult 04/18

  • Part 5: About taking responsibility for the funeral continued

    8

    Parent or child 1 Parent or child 2

    Their full name

    Their address

    Their relationship to the personwho has died

    Their NI number, if you know it.

    Their date of birth / / / /

    Mr / Mrs / Miss / Ms Mr / Mrs / Miss / Ms

    Postcode Postcode

    Letters Numbers Letter Letters Numbers Letter

    Tell us about any other surviving parents or children of the person who hasdied. It is important that you give us as much information as possible.

    Do they get a qualifying benefit?Please see the notes booklet.

    Yes

    No

    Please tell us which benefits they are getting. If you dont know,write Dont know in the box.

    SF200 04/18

    If they dont get a qualifying benefit, are they resident in a careestablishment and their expenses are met in whole or in part bythe Local Authority or Local Government?

    Did they keep in touch with theperson who has died? Yes

    NoHow often did theykeep in touch?

    How did they keep in touch? For example, by visit, telephoneorletter.

    YesNo

    How often did theykeep in touch?

    How did they keep in touch? For example, by visit, telephoneorletter.

    Yes

    No

    Dont know We wil

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