student fnance wales cylld myfyrwyr cymru Educaton Mantenance Allowance (EMA) Fnancal Detals Form 2017/18 sound advce on STUDENT FINANCE EMA Educaton Mantenance Allowance (EMA) 2017/18 /A
How to complete the Fnancal Detals Form Follow the nstructons, we ll tell you what questons you need to answer and what ones you can skp. Secton 1 asks about you and who you lve wth, t wll also tell you who needs to complete the rest of the form. Secton 2 wll ask about your household fnancal detals. Dependng on your stuaton, ether your parent(s)/ guardan(s) or you (and your partner, f you have one) wll need to complete ths secton. Whoever completes ths secton wll need ther Natonal Insurance number to hand. Secton 3 contans your agreements whch must be sgned. You need to complete all of the questons you re asked to. Any mssng nformaton wll delay your applcaton. Where we ask for evdence we wll need t before your applcaton can be fully processed. Any mssng evdence wll delay your applcaton. Use the notes Where e you see ths you should check the notes for specfc nformaton to help you complete a queston or secton. Where you see ths you need to send us evdence. Use the notes to fnd out exactly what you need to send. All documents you send must be orgnals, we can t accept copes. We wll send your orgnals back to you. Addtonal Help and Informaton If you need any help to complete ths form, please call us on 0300 200 4050 (Mncom: 0300 100 1693). Our webste also has lots of helpful nformaton about EMA: www.studentfnancewales.co.uk/ema You can get forms and gudes n Bralle, large prnt or audo. Send your name and address along wth a message tellng us what format you requre to: bralleandlargefonts@slc.co.uk or you can telephone us on 0141 243 3686. Note: ths emal address and telephone number can only deal wth requests for alternatve formats of forms and gudes. 2
Secton 1 Personal detals 1.1 Student detals Forename Surname 1.2 Do you lve wth your parents? Yes Your parent(s)/guardan(s) need to complete Secton 2 then both of you need to complete Secton 3. No You (and your partner, f you have one)need to complete Secton 2 then both of you need to complete Secton 3. 3
Secton 2 Fnancal detals Secton 2 s dvded nto four parts. Read the followng for a quck summary of each part. Part A Tell us your name and some other personal nformaton ncludng your Natonal Insurance number. Part B Answer every queston. Part C Only complete f nstructed. Part D Answer every queston. Who completes ths secton? Queston 1.2 told you who needs to complete ths secton for your applcaton. How to complete ths secton If you are a sngle parent/guardan of the student Enter your nformaton as, leave blank. If there are two parents/guardans n the student s household Complete ths secton wth nformaton for both and. If you re an ndependent student wth a partner Enter your nformaton as, your partner needs to enter ther nformaton as. If you re an ndependent student wthout a partner Enter your nformaton as, leave blank. If you re self assessed read page 3 of the notes for more nformaton. If you re not self assessed you can use your P60 to complete ths secton. Data Sharng We wll share and check the detals you gve us wth HM Revenue & Customs, allowng us to gan the most accurate nformaton possble. Ths can only be done f you have a vald Natonal Insurance (NI) number. Part A 2.1 Personal detals Frst name Frst name Famly name Famly name Date of brth DAY MONTH YEAR - - Relatonshp to student (f you re the student, wrte N/A) Date of brth DAY MONTH YEAR - - Relatonshp to student Please provde your NI number below - - go to Part B Please provde your NI number below - - go to Part B 4
Secton 2 Fnancal detals (contnued) Part B Fnancal nformaton for tax year 2015-16 How to complete Part B Answer every queston. Where you answer Yes to a queston you must gve gross ncome amounts. Any amounts gven must be for the tax year startng 6 Aprl 2015 and endng 5 Aprl 2016. If you leave any queston blank n Part B we wll not be able to process ths applcaton. If you don t receve a specfc type of ncome lsted n a queston, wrte n/a. Do I need to send any evdence of fnancal detals wth ths applcaton? No, you don t need to send any evdence of your fnancal detals now, but we may wrte out to request ths at a later date. What f my ncome has dropped snce 2015-16? If your household ncome has permanently changed snce tax year 2015-16, refer to e page 5 of the notes for more nformaton. 2.2 Were you n recept of Income Support or ncome-related Employment and Support Allowance? No Yes No Yes 2.3 Were you n recept of Unversal Credts? No Yes No Yes 2.4 Dd you receve any ncome from salary, wages, taxable state benefts or from occupatonal or prvate pensons? No go to 2.5 No go to 2.5 Total ncome from salary/wages Total ncome from taxable state benefts Total ncome from occupatonal penson(s) Total ncome from prvate penson(s) 5
Secton 2 Fnancal detals (contnued) 2.5 Dd you receve any ncome from a state retrement penson? No go to 2.6 No go to 2.6 Total non-lump sum amount receved Total lump sum amount receved 2.6 Dd you receve any ncome from savngs and nvestments? No go to 2.7 No go to 2.7 Total nterest from UK banks, buldng socetes and unt trusts Total ncome from UK lfe nsurance gans, securtes and partnershps Total ncome from UK nvestments and dvdends Total ncome from foregn nvestment and dvdends 2.7 Dd you receve any taxable benefts n knd? Total ncome from taxable benefts n knd No go to 2.8 No go to 2.8 2.8 Dd you receve any other ncome durng tax year 2015-16 that you have not told us about n Part B? No go to Part D Yes go to Part C No go to Part D Yes go to Part C 6
Secton 2 Fnancal detals (contnued) Part C Any other ncome How to complete Part C Answer every queston. Where you answer Yes to a queston you must gve gross ncome amounts. Any amounts gven must be for the tax year startng 6 Aprl 2015 and endng 5 Aprl 2016. If you leave any queston blank we wll not be able to process ths applcaton. If you don t receve a specfc type of ncome lsted n a queston, wrte n/a. 2.9 Dd you receve any ncome from self-employment? No go to 2.10 No go to 2.10 Total taxable proft from busnesses Total taxable proft from partnershps 2.10 Dd you receve any ncome as a Mnster of relgon? No go to 2.11 No go to 2.11 Total taxable ncome mnus expenses that are not ncluded on your P60 or P11D 2.11 Dd you receve any other taxable ncome or lump sums? Total ncome receved No go to 2.12 No go to 2.12 2.12 Dd you receve any ncome from property lettngs? Total ncome receved No go to 2.13 No go to 2.13 7
Secton 2 Fnancal detals (contnued) 2.13 Dd you receve any ncome from UK trusts? No go to 2.14 No go to 2.14 Total ncome receved 2.14 Dd you receve any foregn ncome? Total ncome receved No go to 2.15 No go to 2.15 2.15 Dd you receve any ncome from an overseas penson? Total ncome receved No go to 2.16 No go to 2.16 2.16 Dd you receve any other overseas ncome and gans? No go to Part D No go to Part D Total ncome receved go to Part D go to Part D 8
Secton 2 Fnancal detals (contnued) Part D Deductons How to complete Part D Answer every queston. Where you answer Yes to a queston you must gve gross deducton amounts. Any amounts gven must be for the tax year startng 6 Aprl 2015 and endng 5 Aprl 2016. If you leave any queston blank n Part D we wll not be able to process ths applcaton. If you don t receve a specfc type of deducton lsted n a queston, wrte n/a. 2.17 Dd you pay any prvate penson contrbutons? No go to 2.18 No go to 2.18 Total amount you pad 2.18 Dd you pay any Addtonal Voluntary Contrbutons (AVCs)? No go to 2.19 No go to 2.19 Total amount you pad 2.19 Dd you have any allowable expenses on whch you clamed tax relef? No go to Secton 3 No go to Secton 3 Total amount on whch you clamed tax relef go to Secton 3 go to Secton 3 9
Secton 3 Agreements How to complete Secton 3. If you are an ndependent student wth no partner. Complete the Student Agreement below, leave the Parent/Guardan/Partner Agreement blank. If you are an ndependent student wth a partner. You complete the Student Agreement, your partner needs to complete the Parent/Guardan/Partner Agreement as. If you are a dependent student n a sngle parent household. You complete the Student Agreement, the parent who completed Secton 3 needs to complete the Parent/ Guardan/Partner Agreement as. If you are a dependent student n a two parent household. You complete the Student Agreement, and your parents need to complete both and of the Parent/Guardan/Partner Agreement. Student Agreement By sgnng ths declaraton you are confrmng that: the nformaton you wll gve on ths form s correct and complete to the best of your knowledge and belef; you wll submt supportng evdence n accordance wth the accompanyng notes; you understand that any attempt to dshonestly obtan EMA shall be treated as fraud and may result n crmnal and/or cvl proceedngs aganst you; you have read and understood the Data Protecton Statement ncluded on page 9 of the accompanyng notes; and you have read and understood these statements. Student full name (n BLOCK CAPITALS) Student sgnature Today s date DAY MONTH YEAR - - Parent/Guardan/Partner Agreement By sgnng and datng ths declaraton you confrm that: the nformaton gven on ths form s correct and complete to the best of your knowledge and belef; you understand that any attempt to dshonestly obtan EMA shall be treated as fraud and may result n crmnal and/or cvl proceedngs aganst you; you have read and understood the Data Protecton Statement ncluded on page 9 of the accompanyng notes; and you have read and understood these statements. Full name (n BLOCK CAPITALS) Full name (n BLOCK CAPITALS) Sgnature Sgnature Today s date Today s date DAY MONTH YEAR DAY MONTH YEAR - - - - 10
! 3 thngs to remember 1 Get your EMA! Make sure you ve answered all the questons and sectons we need you to and then return your fully completed form as soon as possble. 2 Check the postage Make sure that your completed form s weghed and the postage costs are fully pad. Remember to ask for proof of postage! 3 Send the form Return your completed form to the address below: EMA Wales Customer Servces PO Box 5596 Glasgow G52 9BR 11