Child Tax Credit Application Form

This is money given to anyone who is responsible for at least one child. Anyone over 16 years of age who is responsible for a child can claim for CTC so long as their income is of a particular limit. One can either claim CTC as an individual or a couple when married. A child is considered to be anyone below the age of 16.

PERSONAL DETAILS

i) Name of applicant

First name                                            Middle name                                        Surname

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ii) Date of Birth

Day ———–    Month———– Year———-

iii) Marital Status

Married                       Single                  Divorced

CONTACTS

Address

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Town —————————-

City —————————–

Telephone ————————-

Details of Child/ Children you are responsible for:

Name                                                             Age

1. ———————————-                 ———————————

2. ———————————-                 ———————————-

What is your relationship with the child/ children?

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EMPLOYMENT DETAILS

You are (Tick one)

a. Employed  full time

b. Employed part time

c.  Self employed

d.In business

e. Unemployed

Give details of above information if your answer is a, b, c or d

Address of employer/ business

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Telephone

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FINANCIAL DETAILS

Gross annual income

———————————–

Income after tax

———————————–

Liabilities

———————————–

Assets

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BANK DETAILS

Account no. ————————-   Branch ————————-   Code ——————–

———————                                              ———————-

Signature of applicant/s                                          Date

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