ࡱ>  bjbj££ 4 ??8|{$[;q q q q =./t/<V:X:X:X:X:X:X:==?`X:/*L=.//X:??q q ;555/F?Rq q V:5/V:557t"8q p` `0@j8B:+;0[;r8,?@E0t?@88?@8//5/////X:X:5///[;////?@///////// :  Housing Benefit/Council Tax Reduction Self Employed eForm  Section 1  About Yourself Claim ref  FORMTEXT        Full name  FORMTEXT        Date of Birth  FORMTEXT       National Insurance no  FORMTEXT       Current Address  FORMTEXT       Phone No  FORMTEXT       Email  FORMTEXT       Section 2  About Your Business Are you officially registered as a Director? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If you are we will also need to see your wage slips covering the last two consecutive months. Do you have more than one business? Please complete a separate form for each business.  Business name  FORMTEXT        Business Function  FORMTEXT        Bus. start date  FORMTEXT       Avg hours per week: 0-15 16-29 30+  FORMCHECKBOX   FORMCHECKBOX   FORMCHECKBOX  Address from which the business is operated:  FORMTEXT       Is your business a partnership? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If yes, what percentage of the profit / loss is yours  FORMTEXT       Is your husband/wife/partner a partner in the business? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If yes, what percentage of the profit / loss is theirs  FORMTEXT       Are there any other people on the payroll of the business? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If yes, how many  FORMTEXT       Do you use part of your own home for business purposes? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If yes please give details  FORMTEXT       Do you receive regular tips or commission? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If yes, please confirm the amounts and frequency  FORMTEXT       Is it reasonable to assume that the trading figures for the next 6 months will be similar to those that you are declaring? If  No please explain why below Yes  FORMCHECKBOX  No  FORMCHECKBOX   FORMTEXT       Do you have accounts (prepared by an accountant) for the last financial year? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If  Yes please send us the original document(s) and sign the declaration on the back of this form. If No then please complete section 3 of this form. Section 3 Statement of Accounts Please provide figures for the last financial year. If you have not been trading for a full year please provide figures for the last six months. If you have been trading for less than six months, please provide figures for the last three months. If you have only just started trading you should provide an estimate of your income and expenditure for the next three months. Period of assessment DO NOT EXCEED 52 WEEKS  Projected  FORMCHECKBOX  3 months  FORMCHECKBOX  6 months  FORMCHECKBOX  Annual  FORMCHECKBOX  Period covered From  FORMTEXT       To  FORMTEXT       BEFORE DEDUCTING TAX/NATIONAL INSURANCE/OR EXPENSES  Total gross income for the above period (Sales or takings)  FORMTEXT 0.00  Total income from grants or government loan schemes  FORMTEXT 0 Please give details  FORMTEXT       Business Expenses  Please declare expenses for the whole assessment period, NOT weekly or monthly figures. For example; if you pay 100 per month for rent of a stall and your assessment period covers a full year you will need to input 1200 as your rent expense. Enter all your expenses into the table. Where possible use the categories provided. The categories listed should cover most situations. Some boxes have a % next to them. This is for situations where only part of the expense was for business use, so, for example, if you pay 500 for your mobile, but only use it half the time for work then you should enter the full figure of 500 and then 50% as the proportion that is for business use. 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FORMTEXT      Replacement of business asset FORMTEXT      Business Insurance FORMTEXT      Interest on loan (business only) FORMTEXT      Heating FORMTEXT       FORMTEXT      %Repair of business asset FORMTEXT      Lighting FORMTEXT       FORMTEXT      %Travel expenses (train, bus, parking) FORMTEXT      Landline FORMTEXT       FORMTEXT      %Subscriptions to professional Bodies FORMTEXT      Mobile FORMTEXT       FORMTEXT      %Pension contributions FORMTEXT      Internet FORMTEXT       FORMTEXT      %Materials/Supplies FORMTEXT       Motor Expenses MOT FORMTEXT      Who owns the vehicle/s? Self  FORMCHECKBOX  Business  FORMCHECKBOX Motor Repairs FORMTEXT      If vehicle is business owned, do you use it for anything other than business?Yes  FORMCHECKBOX  No  FORMCHECKBOX Motor Fuel Costs FORMTEXT      Car lease FORMTEXT      If applicable, please state what percentage of vehicle use is business use. FORMTEXT      %Motor Insurance FORMTEXT       Other Expenses  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        Please note you will be required to submit supporting evidence of the following: Any expenses over 1000 Vehicle repair expenses Loan or hire purchase agreements Evidence that you have permission to run a business from home (this could be your lease or a letter from your landlord/letting agent) The City of Edinburgh Council retains the right to request evidence/clarification of any expense you declare. Section 4  Declaration I certify that the self employed information I have given on this form is true and correct.  Signature  FORMTEXT       Date  FORMTEXT       If someone else has filled in this form on your behalf please ask them to complete this section below:  Signature  FORMTEXT       Date  FORMTEXT        Print Name  FORMTEXT        Relationship to self employed individual  FORMTEXT       Section 5  Any further information Use the box below to tell us anything else you feel may be relevant in regards to your self employment.  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