Current Year Income Assessment Form - Academic Year 2016/17 Page 2
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5After I have sent you my completed form, do I need to do anything else?
Yes, but not just now. After tax year 2016-17 has ended, we will contact you and ask you to confirm, with
evidence, your actual earnings for that tax year.
These evidence items will be the same documents that you send to, or receive from, HM Revenue & Customs.
For example, a P60, SA200 or Self Assessed Tax Return.
If your actual income is different from your estimates we may adjust the amount of student finance awarded. If
we have paid the student(s) too much we may have to recover student finance from them.
section
A
tax credits and income support
Person 2
Person 1
Q1
Does your tax year end
on 5 April 2017?
Yes
No
Yes
No
DAY
MONTH
YEAR
DAY
MONTH
YEAR
If no, when does it end?
/
/
/
/
If your tax year ends on a date other than 5 April 2017, please provide us with information for
!
your tax year that will end during the academic year 2016/17.
Person 2
Person 1
Q2
Will or do you expect to receive Working Tax
Credits or Child Tax Credits?
Yes
No
Yes
No
Yes
No
Q3
Will you receive Income Support or Universal Credit?
Yes
No
section
B
your financial information
How to answer the questions in this section:
• If you answer ‘Yes’ to any of these questions you will need to provide the total amount of gross income you
expect to receive for that income type.
• The total amount should include all earnings for the full tax year. For example, if you were made redundant
part-way through the year, you need to include earnings from 6 April 2016 up to the date of your
redundancy and any income you expect to receive from then up to 5 April 2017.
• For pension payment questions, please tell us the amount of the pension you expect to receive from the
first month you receive it until the end of the tax year.
• If you answer ‘No’ to any question, you are telling us that you do not expect to receive any income from
that particular income type.
Person 1
Person 2
Do you expect to receive any income from salary, wages,
Yes
No
Yes
No
Q1
taxable state benefits or from occupational or private pensions?
£
£
a
Total expected income from salary / wages
£
£
b
Total expected income from taxable state benefits
£
£
c
Total expected income from occupational pension(s)
£
£
d
Total expected income from private pension(s)
SFW/CYI/1617
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