OPEN - ESDS

. . ,—-. . .
33
Per No. Per No. Per No.
PRqE 533
Frs
~an~
(r,3
am)
fi-e~n
WV-L \ .............. .............. .............. .............. .............. ............. I
1 I 1 I
(c) Family Credit/Family
P; Q P; Q P;
Income Supplement - Ask (i) - (iv)
No -. 2 2 2 - Go to (d)
(i) For how many weeks
did you receive this
benefit? - <
.............*............. .............-............. .............. ............ !
IN;#ii~y)
\
\ @
at was the amount of
‘fi)~e~it you~as~received?z
4
................... ........ ................... ........ ................... ........
m
Frs8EN
Q@6c
(531)
~
(iii) How long did
this cover?
Enter period
code —a
P~RC531 (s32) Q056C 3
............................ ............................ ............................
If code9,
specify period
I I
(iv) Are you receiving Yes -0 1 1 1
benefit at present? No -- 1-Ask (d)
I~$125Y[533)QO!56C4A I I I
I I I I
1 I I I
I
(d) Income Support/ ‘ SUp~E~ : (5330 ; Q05@ ;
Supplementary Benefit Yes ,—* 1 1 I - Ask (i) - (iv)
IN?122a (534) Qo56b 1
2 2 2 -SU57
(i) For how many week
did you receive this ●
benefit?
............. .............. ............
- Ask (ii)
su~BqMT (53
(ii) What was the amount of
benefit you last received? .— ..................
- Ask (ii)
.-
‘0
(iii) How long did Enter period
this cover? code ._w
PERC535 (536) QO%D 3 If Co&9,
............................ ............................ ............................ specify cwriod
(iv) Are you receiving .............................
1
............................. .............................
benefit at present? Yes .—w 1 1 1
No .-. 2 2 2 \1 -sa57
1NR22q [537) Q0561) 4
.
98