OPEN - ESDS

t
Q58 (cent’d)
Prompt Card R (cent’d)
37
(d) Any N.I. or State benefit not ~ .............. .............. .............. .............. .............. .............
I
mentioned earlier?
Is p;s p:s p; Lspecify blow
and ask
1 - i) - (iv)
oTtiBEN(545) QOS%D
1
2 - Goto59
Include Job Release Allowance
War WMms Benefit 1“1 ............................ ............................. I.............................
I
Industrial Widows Pension
I
etc. I I I (F*)
(i) For how many weeks did you
receive this benefit? —
OTHBENfi~ (547) Q05~j) 2
B37
(ii) What was the amount of benefit
you last received? - Ask (iii)
I I I I
(iii) How long did )
this cover? Enter period
?ERC547 (5@) Q058D 3 If code9,
code -. ............................. ............................. ............................ s~ify wriod
(iv) Are you receiving ............................. ............................. .............................
benefit at present? I I I y Ask (iv)
Yes * 1 1 1
No —. X 1 -M59
2 2 “2
~Nll 233 @$ QOS8b 4N ~ I I I
I I I I
I I I I
I I I I
59 In the last 12 months, that is I I I I
since ...................... have you received trade 1 I I I
union sick pay or strike pay, Friendly I I I I
i.,
9
Society benefits, benefits under private 1 I I I
sickness scheme, accident insurance, I I
I
t TIJSICKpy : (553]
hospital savings scheme?
I (3059 I
Yes —a 1 1 1 - Ask (a) - (d)
1N~230 ~55J9 Q05q~ .NO — 2 2 2 -
(a) For how many weeks did you
receive this benefit? — .............. .............. .............. .............. ..............
(b) What was the amount of benefit you
last received?
TUSICBENj (55~
I I I I
Goto60
Ask (b) .
Ask (C)
(c) How Iong did
this cover? Enter period ?ERC5S5 (556) Qo5qC If code 9,
code —~ ............................ ............................. ............................ specify period
(d) Are you receiving benefit at -~ 1
present? ............................. ............................. ............................ Ask (d)
Yes ,—~ 1 1 1
No -. g 2 2 2
-xk~ 102