July 2013 Application for civil legal CIV/FIN aid /4

Financial eligibility for self employed

Please read these notes before completing the form

Filling in the form  You should fill out this form if you are self employed. You should also have filled out Application for civil legal aid – Financial eligibility – Form 2.  Complete the form in capital letters using black ink and put an ‘x’ in the relevant boxes. If a question doesn’t relate to you, please answer it by putting an ‘x’ in the ‘No’ or ‘Not applicable’ box.  Read the notes everywhere you see the information symbol. These give helpful information on completing the form.  We use the information you give to decide if you qualify financially for legal aid. Give us and your solicitor full and honest answers so we can deal with your application quickly.

Please send copies of your Documents and evidence to send documents and not originals. with your application Please don’t use a highlighter  When you see the documents symbol, it on any of the documents you send us. tells you about documents you need to attach as evidence. Read the notes for It’s important that you provide all details of the evidence you need to the documents needed or your provide. application will be incomplete.  If you don’t send the correct evidence If we need to write to you to we can’t ask for documents this will deal with your case. delay our decision.

Returning your form  If you were given this form by your solicitor, please return it to them with all the evidence requested.  If you were sent the form or were asked to complete it by the Scottish Legal Aid Board, please return it with all the evidence requested to: Scottish Legal Aid Board, Thistle House, 91 Haymarket Terrace, Edinburgh, EH12 5HE

 You can also email us your form. Send it to: [email protected] Help with this form Legal Aid  If you need any help with this form you should ask Information Line your solicitor.  You can also get help from the Legal Aid 0845 122 8686 Information Line.

Data Protection Act 1998 – Access to personal data The personal information provided by you or on your behalf will be used in accordance with the Data Protection Act 1998 and for the purpose of the Board’s functions under the Legal Aid (Scotland) Act 1986. You have the right to make a formal request in writing to see the personal information we hold about you, to inspect it and to have it corrected if it is wrong. The Board may receive information about you from certain third parties (for example, some government departments and agencies), or give information to them. However, we will not pass on information about you unless the law allows us to do so. Read these Section A – About you If you are notes as you filling in this fill out the form for form. A1. Legal aid reference someone else, number You will only please give their have this if details and not your you’ve already own. been granted legal aid. A2. National Insurance LETTERS NUMBERS LETTER Find this on your number Majesty’s A3. Are you Male Female most recent P60 or Revenue other forms from and her Customs A4. Forenames . If A5. Surname you hav e a mid dle nam e ent er it her e too.

D D M M Y Y Y Y A6. Dat of birt

A7. Address

Post code

A8. Email We address need a Home telepho ne A9. number Applicant’ Mobile where s daytime you can telep usually hone be numb contact ed er(s) betwee n 9am and 5pm. S B – e Abo c ut t you i r o wor n k

Look F de a copy of the latest B1. H at 3 accounts you have had self e the . prepared, including the follo balance sheet. If you wing state don’t produce ment B2. accounts, provide a s and What copy of the latest Self ‘x’ is Assessment Tax Return the the you made to HM Revenues and Customs box natu and a copy of the tax that re of accu return’s assessment. your ratel y busi desc ness? ribes your circu msta nces. 1.

As tra B3. Ple What ans date and did you 2. beco me As self com empl par oyed Ple or ans did B2, the and com D5. pany 3. start tradi As ng? sha D ng D If this is com less than dir M two years Ple M please go ans to Section B2, Y C. and Y E5. Y 4. Y As con r - P ans l and e a 5. s e As far p Ple r ans o B2, v i and Read these Section C – Self employment less than two Answer these questions if notes as you you became self employed fill out the years form. or your company started trading less than two years C1. How much money do you pay yourself ago. from the business per week/month?

Amount

Weekly

Monthly

H C2. Do you pay any of o your household u expenses through the s business? e h o Yes l d No

e x p e n s e s

c o u l d be C3. If W thin so, what e gs are like w these gas, i elec expenses l trici ? l ty, tele a pho s ne, s mor e C4. s tgag What is e or s your Cou year end ncil y Tax. date? o u D D M r M Y c Y a Y Y s e

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t h i s e. s Custo and a copy of return’s i W h ms, the tax assessment. n i e e c n w e l f ill t Section D – Please tell u o w , Your business us about d r ri partner your i m te o If relationship n a to r with g th D1. Who is t y er business i o t e your partner in partners t o u h is the business? here. They h n fo e m need to sign e , r or and date a S e the b b c e th declaration a u o l an in Section J, l t p f on unless they a y e are the n w A pa opponent in c i o s rt the case. e l f s ne l e r s y s in h l o s yo e o u m ur e o r e bu t k n sin . y t es a e s, I t a T please f r a give y x the y o e names o u n R for all u r d e partne t rs d c a u here. o a c r n s c n D2. Is your Yes ’ e o business t u y partner the No a n o opponent in p g t u the case r a s which you o i , m are d n a making u i d c this a n e e t c legal l t aid a t u o applica c h d tion c e i H for? o n M D3. Are you still involved in u n g n e R t x t e D4. Are you still receiving a s t h v , e e D5. What is the last date yo y n D D M M p e b u r a a e o r l s v e a Please provide i n n a a copy of the d d c n latest accounts e d e d you have had at prepared, a cop e company of t here. late Self Asse E1. How many shares in men the company do you Tax own? Ret you E2. How many shares in mad to H the company have been Rev issued? es a E3. Do you receive Cus dividends from the s an company? cop the retu Yes s asses No ent E4. Do you receive a salary from the SectioP company? Shal e di Yes a sa s e No

t e E5. Are you entitled to a l share of any net profit l made by the company?

u Yes s No a b Your Company o Secretary should u complete a t St a t e m e n t o f E a r ning s Fo r m w ( C I V F i n 3 ) which h you can download a from t www . sl a b .or g . u k . Please provide a s copy of the h latest accounts a you have had r prepared, e including the balance sheet. If y you don’t o produce u accounts, provide a copy of the h latest Self a Assessment Tax v Return you made e to HM Revenues and Customs and o a copy of the tax f return’s assessment. t h Read these Section F - If you are self employed as notes as you fill Farmers a farmer please tell us out the form. here.

F1. Do you live F2. What is the F3. Is the value

Pl ea se pr ov id e a co py of th e la te st ac co un ts yo u ha ve ha d pr ep ar ed , in cl ud in g th e ba la nc e sh ee t. If yo u do n’ t pr od uc e ac co un ts , o e pro r l e a m l cop of y u lat o s Sel u Secti You Asse a on J must me c n – sign Tax a y If this Ret n t you Decl declar n y h know arati ation ma c i ingly ons to say to o n make the Rev n g inform ues t For ation and i e applic you’ve Cus n l ants: provid ms u s ed is and e e true cop and of y y correct tax o o . If ret u u you’re ’s r ’ filling asses d out me a the n l form s i on a I w k Sectio e e compu f ter Othe r u type in y your o h s e name. u a oyers and benefit paying r t e o false offices. r stat a . k eme n nt Y n o o you o may u u w be t pros c a a b ecut o ed. f n o u We r a t chec o l k the o s y infor m o o mati u on e t . you l provi s de e with w third h parti e es r such e as your i empl n

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f a) plication I form is to D / the best w of my/our e belief and M knowledg c e true and M e correct. r t For Y i representatives: f a) I declare Y y that as far as I t know the Y h informati e on I have Y given is i true, n based signatures f upon the o reasonabl

r e m enquiries Date a which I t have been i able to If you o make, have n exercising additi due care onal g and busin i diligence. ess v partn e ers, n pleas D e i copy n D this M page t for h M them i to Y s sign Y and a date. p Y Y Your signature

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D D M Your M Y Y Y Y Date

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