Social Fund Funeral Expenses Payment for an adult Department for Work & By adult we mean: • Someone aged 20 or over, or someone aged 16 to 19 who is not in Pensions full-time, non-advanced education or training. • For all other circumstances please use the form 'Social Fund Funeral Expenses Payment for a child'. Important Information The 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, except public holidays. Calls to 0800 are free from landlines and mobiles. Money belonging to the person who has died can sometimes be released to pay for the funeral if you apply for it. This can even apply before probate or letters of administration or, in Scotland, confirmation, have been granted. You can get more information at www.gov.uk About this form • 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 • This form and the notes are available in Welsh • 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 explain some of the questions we ask you and why we are asking them • Fill in this form with BLACK INK and in CAPITALS • 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 have asked for, including a final funeral bill or contract, you will help us decide quickly if you can get a Funeral Expenses Payment or not • If you have difficultyfilling in this form, don't be worried about asking for help. You can ask a relative, friend or someone at an advice centre to help you but you must sign the form yourself • You must claim a Funeral Expenses Payment within 6 months of the date of the funeral. If you are waiting for a decision on a qualifying benefit, you must still claim within the time limit SF200 adult 05/18 Part 1: About you and your partner Do you have a partner? No D Tell us your details below. We use partner to mean Yes Tell us about you and your partner below. • a person you live with who is your D husband, wife or civil partner, or If your partner is the person who has died do not complete their • a person you live with as if you details in the partner section below but tell us about them in Part 2. are a married couple You Your partner Letters Numbers Letter Letters Numbers Letter National Insurance (NI) number You can findthe number on a National Insurance (NI) number card, letters about benefit, or payslips. If you do not know your National No □ No □ Insurance number, have you ever YesO YesD had one or used one at any time? Surname or family name (including title) �-1�1 - All other names, in full Date of birth Daytime phone number, if you have one. We may need to contact you by phone to get more information or to let you know when we have made a decision on your claim. Please note that our number may show as 0800, unknown or withheld. Mobile phone number if you have one. If you have a mobile phone we will text you to let you know that we have got your claim. Email, if you have one. Current address (including postcode) Please tell us your current address, and tell us your partner's current address, if it's different. 2 !SF200adult 05/18 I Part 2: About the person who has died Their surname or family name Their other names, in full Their date of birth The date they died The date of funeral if known Their address (including post code) Letters Numbers Letter Their National Insurance (NI) number Will the funeral take place in the No □ United Kingdom (UK)? YesD The UK is England, Scotland, Wales and Northern Ireland. If the funeral is not in the UK, in which country will it take place? Please see the notes booklet. If the funeral is not in one of the countries shown, you cannot get help. Did the person who has died have No D We will contact you about this. their main home in the UK? Yes0 I SF200adult 05/18I 3 Part 3: About paying for the funeral Have you or your partner taken No D You will not be able to get a Funeral Expenses Payment. responsibility for the funeral YesD expenses? Is the bill for the funeral in your No □ name or your partner's name? YesD If you ticked No, please say why you are responsible for paying the bill.. For example, someone may have made the arrangements on your behalf because you were ill. Has anyone else claimed a Funeral No □ Expenses Payment for this person? Yes D Please tell us about them. Their full name (including title) Their date of birth Letters Numbers Letter Their NI number Their address (including postcode) Please tell us why they have claimed a Funeral Expenses Payment for this person? 4 !SF200adult 05/18 I Part 4: About benefits Are you or your partner getting any of No □ the following: YesO Please tell us which benefits you are getting • Universal Credit • Income Support • income-based Jobseeker's Allowance • income-related Employment and Support Allowance • Pension Credit • the disability or severe disability If you or your partner are getting Housing Benefit, sen? us the late�t element of Working Tax Credit letter from the council which tells you that you are entitled to Housing • Child Tax Credit Benefit. Send it with this form. • Housing Benefit • Support for Mortgage Interest Are you or your partner waiting to hear No □ about a claim for any of the following: YesO Please tell us which benefits you are waiting to hear about. • Universal Credit • Income Support • income-based Jobseeker's Allowance • income-related Employment and Support Allowance • Pension Credit • the disability or severe disability If you or your partner are a claim for waiting to hear about _ element of Working Tax Credit Housing Benefit, do not wait until you hear about the claim. • Child Tax Credit Send this form to us. • Housing Benefit You will get a letter from the council to tell you if you can get • Support for Mortgage Interest Housing Benefit. Send this letter to us as soon as you can. Now go to Part 5. 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. I SF200adult 05/18I 5 Part 5: About taking responsibility for the funeral Was the person who died your No □ partner who you were living with at Yes D Please go to Part 6. the time of their death, or you had been living with immediately before one or both of you moved into a care home? We use partner to mean: • a person you live with who is your husband, wife or civil partner, or • a person you live with as if you are a married couple 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. Is there a surviving partner of the No □ person who has died? Yes D Please tell us about them. Their full name (including title) Their address (including postcode) Please tell us why this person is not claiming the Funeral Expenses Payment. Did the person who has died have any No D Please go to page 12. other survivingparents or children? YesO Do not include yourself or any children of the person who has died if Child Benefit is still in payment for them. 6 !SF200adult 05/18 I Part 5: About taking responsibility for the funeral continued Had the relationship between the No □ Please tell us about the other surviving parents or children on person who has died and any of pages 8 and 9. If you need more space, please use a separate the survivingparents or children sheet of paper. Remember to put your full name and NI number broken down? on any separate sheet of paper you use. Yes D Please tell us their full names. Please tell us how the family relationship had broken down, and for how long. ISF200adult 05/18I 7 Part 5: About taking responsibility for the funeral continued Tell us about any other surviving parents or children of the person who has died. It is important that you give us as much information as possible. Parent or child 1 Parent or child 2 Their full name (including title) Their address (including postcode) Their relationship to the person who has died Their date of birth Letters Numbers Letter Letters Numbers Letter Their NI number, if you know it. Yes D Please tell us which benefits they are getting. If you don't know, Do they get a qualifying benefit? Don't know Please see the notes booklet. write in the box. No D If they don't get a qualifying benefit, are they resident in a care establishment and their expenses are met in whole or in part by the Local Authority or Local Government? Don't know D We will contact Don't know D We will contact you about this.