Form SF200 Child
About you
Q1. Do you have a partner?
Options: No; Yes
Guidance: We use partner to mean: • a person you live with who is your husband, wife or civil partner, or • a person you live with as if you are a married couple.
About you
Q2. Your National Insurance (N I) number
Guidance: You can find the National Insurance (N I) number on a National Insurance (N I) number card, letters about benefit, or payslips.
About you
Q3. If you do not know your National Insurance (N I) number, have you ever had one or used one at any time?
Options: No; Yes
About you
Q4. Your surname or family name
About you
Q5. All your other names, in full
About you
Q6. Your date of birth
Guidance: DD/MM/YYYY
About you
Q7. A phone number we can contact you on, if you have one
Guidance: Please note that our number may show as 0800, unknown or withheld.
About you
Q8. Your email, if you have one
About you
Q9. Your home address
Guidance: Where you normally live.
About your partner
Q10. Your partner’s National Insurance (N I) number
Guidance: You can find the National Insurance (N I) number on a National Insurance (N I) number card, letters about benefit, or payslips.
About your partner
Q11. If you do not know your partner’s National Insurance (N I) number, has your partner ever had one or used one at any time?
Options: No; Yes
About your partner
Q12. Your partner’s surname or family name
About your partner
Q13. All your partner’s other names, in full
About your partner
Q14. Your partner’s date of birth
Guidance: DD/MM/YYYY
About your partner
Q15. A phone number we can contact your partner on, if they have one
Guidance: We may need to contact your partner by phone to get more information or to let them know when we have made a decision on your claim. Please note that our number may show as 0800, unknown or withheld.
About your partner
Q16. Your partner’s email, if they have one
About your partner
Q17. Your partner’s home address
About the child who has died
Q18. Are you claiming expenses for the funeral of a child who was stillborn?
Options: No; Yes
About the child who has died
Q19. Their surname or family name
About the child who has died
Q20. Their other names, in full
About the child who has died
Q21. Their date of birth
Guidance: DD/MM/YYYY
About the child who has died
Q22. Their address
About the child who has died
Q23. Their National Insurance (N I) number, if they have one
About the child who has died
Q24. The date they died
About the child who has died
Q25. The date of funeral if known
About the child who has died
Q26. Will the funeral take place in the United Kingdom (UK)?
Options: No; Yes
Guidance: The UK is England, Scotland, Wales and Northern Ireland.
About the child who has died
Q27. If the funeral is not in the UK, which country will it take place in?
Guidance: Please see the notes booklet. If the funeral is not in one of the countries shown, you cannot get help with a funeral payment.
About the child who has died
Q28. Did the child who has died have their main home in the UK?
Options: No; Yes
Guidance: We will contact you about this.
About paying for the funeral
Q29. Have you or your partner agreed to pay either part or the full funeral expenses?
Options: No; Yes
Guidance: You may not be able to get Funeral Expenses Payment.
About paying for the funeral
Q30. Is the final bill for the funeral or the signed contract in your name or a partner’s name?
Options: No; Yes
Guidance: The contract is the signed agreement between you and the funeral director. If you ticked No, please tell us why you are responsible for paying the bill. For example, someone may have made the arrangements on your behalf because you were ill.
About paying for the funeral
Q31. Has anyone else claimed a Funeral Expenses Payment for this person?
Options: No; Yes
About paying for the funeral
Q32. Please tell us about them.
About benefits
Q33. Are you or your partner claiming any of the following: • Universal Credit • Income Support • income-based Jobseeker’s Allowance • income-related Employment and Support Allowance • Pension Credit • the disability or severe disability element of Working Tax Credit • Child Tax Credit • Housing Benefit • Support for Mortgage Interest.
Options: No; Yes
About benefits
Q34. Are you or your partner waiting to hear about a claim for any of the following: • Universal Credit • Income Support • income-based Jobseeker’s Allowance • income-related Employment and Support Allowance • Pension Credit • the disability or severe disability element of Working Tax Credit • Child Tax Credit • Housing Benefit • Support for Mortgage Interest.
Options: No; Yes
Guidance: If you or your partner are waiting to hear about a claim for Housing Benefit, do not wait until you hear about the claim. Send this form to us. You will get a letter from the council to tell you if you can get Housing Benefit. If you or your partner are getting Housing Benefit, send us the latest award letter from the council which shows your claim award details for Housing Benefit. If you or your partner are not getting, or waiting to hear about a claim for any of the above benefits, you will not be able to get a Funeral Expenses Payment.
About taking responsibility for the funeral
Q35. Please tell us your relationship to the child who has died.
About taking responsibility for the funeral
Q36. Did you receive Child Benefit for the child who has died?
Options: No; Yes
Guidance: If you did not receive Child Benefit, please tell us why. This may be because the child died before you were able to claim. Do they or their partner get a qualifying benefit? Please see the notes booklet for a list of qualifying benefits.
About taking responsibility for the funeral
Q37. Did the child who has died have a parent who was not living in the same household?
Options: No; Yes
About taking responsibility for the funeral
Q38. Please tell us about them.
About taking responsibility for the funeral
Q39. Can we get in touch with the funeral director for more information?
Options: No; Yes
Guidance: Although we will not be able to decide if you can get a Funeral Expenses Payment until we have received the final funeral bill or the signed contract, make your claim straight away.
About taking responsibility for the funeral
Q40. Do you have any other bills for things not included on the funeral estimate or bill?
Options: No; Yes
Guidance: For example, flowers or a wreath. Please send your receipts with this form, if you have them.
About taking responsibility for the funeral
Q41. Did you have any travel expenses to arrange or to attend the funeral?
Options: No; Yes
Guidance: We may be able to pay for either: • one return journey to arrange the funeral, or • one return journey to go to the funeral. You must remember to send us all the documents we ask for. If you do not, your claim may be delayed.
About taking responsibility for the funeral
Q42. Did you need additional death certificates or other documents to release insurance or other money of the person who has died?
Options: No; Yes
Guidance: For example, a full death certificate.
About the estate
Q43. Have you already applied for grant of representation, letters of administration or confirmation, or have you instructed a solicitor to apply on your behalf?
Options: No; Yes
About the estate
Q44. If you have not already applied for grant of representation, letters of administration or confirmation, do you intend to apply, or instruct a solicitor to apply on your behalf?
Options: No; Yes
About the estate
Q45. Is someone else sorting out the financial affairs of the person who has died?
Options: No; Yes
About money available or due to pay for the funeral
Q46. Is there any money available or due to you or a member of your family to pay for the funeral?
Options: No; Yes
Guidance: By your family we mean your partner or any children or qualifying young persons living in your household who you are responsible for. We use child to mean a person aged under 16 who you are getting Child Benefit for. Please send us the last bank statement. We use qualifying young person to mean a person aged 16, 17, 18 or 19 who you are getting Child Benefit for.
About money available or due to pay for the funeral
Q47. Is there any cash belonging to the child who has died?
Options: Do not know; No; Yes
Guidance: We will contact you about this. Do not include any of your personal savings. Any assets of the child who has died must be used to pay the funeral bill before any other bills are paid. We will not take into account any arrears of benefit or any lump sum Bereavement Payment. We will also not take into account any contributions from charities, friends or relatives towards the cost of the funeral.
About money available or due to pay for the funeral
Q48. Does the child who died have any money in their accounts at the date of death?
Options: Do not know; No; Yes
Guidance: For example, in a bank, building society, credit union or post office card account. Please send us final statements from the accounts of the child who has died.
About money available or due to pay for the funeral
Q49. Were any of the savings in a joint account?
Options: No; Yes
About money available or due to pay for the funeral
Q50. Have the savings been transferred to the other joint account holder?
Options: No; Do not know; Yes
Guidance: We will contact you about this.
About money available or due to pay for the funeral
Q51. Is there any money in an Independent Savings Account?
Options: Do not know; No; Yes
Guidance: We will contact you about this.
About money available or due to pay for the funeral
Q52. Is there any money from insurance policies?
Options: Do not know; No; Yes
Guidance: We will contact you about this.
About money available or due to pay for the funeral
Q53. Is there any money from a burial club?
Options: Do not know; No; Yes
Guidance: We will contact you about this.
About money available or due to pay for the funeral
Q54. Is there any money from a prepaid funeral-plan?
Options: No; Yes
Guidance: Has the funeral-plan been paid for and does it pay some or all of the funeral costs? Please send us a copy of the original funeral-plan and any documents you have from the provider showing the items and services the plan provides for this funeral.
About money available or due to pay for the funeral
Q55. Is there any other money available to pay for the funeral?
Options: Do not know; No; Yes
Guidance: Do not include any of your personal savings. We will contact you about this.
About money available or due to pay for the funeral
Q56. Have you already paid the funeral bill, either in full or in part?
Options: No; Yes
About the account you want to use
Q57. Name of the account holder
Guidance: Please tell us the name of the account holder exactly as it is shown on the chequebook or statement.
About the account you want to use
Q58. Name of the bank or building society
Guidance: Full name of the bank or building society.
About the account you want to use
Q59. Sort code
Guidance: Tell us all 6 numbers, for example 12-23-56.
About the account you want to use
Q60. Account number
Guidance: Most account numbers are 8 numbers long. If your account number has fewer than 10 numbers, please fill in the numbers from the left.
About the account you want to use
Q61. Building society roll or reference number
Guidance: If you are using a building society account you may need to tell us a roll or reference number. This may be made up of letters and numbers, and may be up to 18 characters long. If you are not sure if the account has a roll or reference number, ask the building society.
More information
Q62. Please use this space to tell us anything else you think we might need to know.
Guidance: If there is not enough space, please use a separate sheet of paper. Make sure that you put your full name and National Insurance (N I) number on each separate sheet of paper you use.
For people filling in and signing this form for someone else
Q63. Please tell us why you are filling in and signing this form for someone else.
For people filling in and signing this form for someone else
Q64. Your address
For people filling in and signing this form for someone else
Q65. Postcode
For people filling in and signing this form for someone else
Q66. A phone number we can contact you on.
For people filling in and signing this form for someone else
Q67. Your full name
For people filling in and signing this form for someone else
Q68. Your date of birth
Guidance: DD/MM/YYYY
For people filling in and signing this form for someone else
Q69. Signature
For people filling in and signing this form for someone else
Q70. Date