IWC eForms
ALL FIELDS MARKED WITH A * ARE REQUIRED ENTRIES
Change of Circumstances

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Change of Circumstances End of Income Support/ Income Based Job Seekers Allowance
Please complete this form if your Income Support or Income Based Job Seekers Allowance has ceased.
Completed application forms should be returned to:
Isle of Wight Council, Council Offices,
Sandown, Isle of Wight
PO36 9EA
For Official Use Only Date received
HB Ref:
Date of Request:
Date of Issue:
Benefit Claim number
Part 1 About you and your partner
* Do you have a partner who normally lives with you?

By partner we mean someone to whom you are married or live with as if you are married to them or a Civil Partner or a person you live with as if you are Civil Partners.

If you have a partner, you must answer all the questions about them, as well as yourself.
You Your partner
Last name
Other names
Any other last names you have used
Title (Mr, Mrs, Ms and so on)
* Address including flat, room or caravan number if you have one. Do not tell us your partner's address if it is the same as yours.

* Do you currently reside at this address?
* Date of birth
dd/mm/yyyy
dd/mm/yyyy
National Insurance number
You can find this on payslips or letters from social security or the tax office. We cannot decide your claim if we do not have your National Insurance number.

If you or your partner do not have a National Insurance number, or cannot find it, tick appropriate box.

Your daytime phone number.
You do not have to tell us this, but it may help us to deal with your claim more quickly.

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