Summary of information entered

Getting started
Your date of birth Your sex Do you have a partner? Do you have any dependent children aged under 20 living with you? Are you claiming Jobseeker's Allowance because Employment & Support Allowance stopped since 5 August 2012? Have you had Jobseeker's Allowance since 6 March 2012 ? In total, do you have savings of more than 16000? 1 November 1987 Female No No No No No

Your claim
If you would like an email mona_ym@hotmail.com acknowledgement when you submit your claim, please enter your email address Do you want to claim Council Tax No Benefit? Do you want to claim Housing Benefit? No

Pregnancy and childbirth

Are you pregnant? Have you had a baby in the last 12 months? No No

Work
Are you available and looking for work? Yes Do you have a job at the moment, paid or No unpaid? Do you have any restrictions imposed by No the Home Office on your right to work in this country?

Current benefits
Do you have an illness or disability that prevents you from working? No

Existing benefits
1

Are you currently receiving Housing Benefit? Are you currently receiving Council Tax Benefit?

No No

When your claim will start

Online claims begin on the date they No are submitted. In very exceptional circumstances only, it may be possible for a claim to start from an earlier date and then only with a valid reason provided. Do you want your claim to start from an earlier date?

When we can contact you

Please indicate any times you are not available for us to contact you within the next few days, to arrange a 'new jobseeker interview' weekends and fridays

Personal details
Title First name Middle name Surname Relationship status Nationality National Insurance (NI) Number Miss Mona Yousuf Mohamoud Single Somali SC510756A

Where you live

Are you in a residential care home, a nursing home or residential accommodation? Yes

Contact information
Your address status Where you live Would you like us to send your post to a different address? Daytime contact number Contact number type I have a permanent residential address 20 Wilsmere Drive, NORTHOLT, Middlesex, UB5 4JA, England No 07983554741 Mobile

Is this a specially adapted phone for the No deaf, hard of hearing or speech-impaired (known as a Textphone)? Do you have another contact number? Yes Please provide another number you can 02084228743 be contacted on If you need us to provide an interpreter when we contact you, please select the language required

Family and relationships

Have you separated from someone who used to be your partner in the 26 weeks before the date you want your claim to start? No

Disability
Have you ever been on the local authority No register for blind persons?

Immigration
Are you subject to immigration control No rules when entering or residing in this country? Have you returned to or arrived in the UK No in the last two years?

Working or claiming benefits abroad

Have you worked or claimed benefit outside the United Kingdom in the last five years? No

Training allowance
Are you receiving a training allowance? No

Tax and tax credits

What is your tax district number? What is your tax reference number? Are you getting Child Tax Credit or Working Tax Credit? Neither

Stopping Work Temporarily

Have you been temporarily laid off, are No you on short-time work or has work been temporarily stopped?

Previous work
Have you received, or do you expect to receive, any payments because a job ended in the last 12 months? Have you had any jobs that have ended in the last six months? No No

Education and training

Have you been on any government or vocational (work-related) training scheme during the last four years? Are you currently registered on a course of study? Have you been a student during the last four years? Are you on Work Based Learning for Young People / Skillseekers? No No Yes No

Your previous study

Other than courses you are currently registered on, how many courses have you been on in the last four years? Please enter a name for your previous course 1 that can be used when asking further questions 1 BSc Honours Biomedical Science

About your previous study: BSc Honours Biomedical Science

When did you start on this course? When did you finish on this course? Did your local authority pay your course fees? Was the course a sandwich course? Was the course part-time? 18 September 2008 9 June 2011 Yes No No

Your pensions

Have you received, or are you likely to No receive, any payments made as part of the Armed Forces Compensation Scheme? Do you receive a pension now, or expect No to receive one in the next three years?

Current benefits
Do you currently receive any benefits or help with mobility? No

Potential benefits
Are you waiting to hear about any benefits you've claimed? No

Previous benefits
Have you made any other benefit claims No before (other than those you are currently receiving or waiting to hear about)? Have you been on jury service in the last No 12 weeks?

Caring
Are you a carer for someone else? Do you have a carer? No No

Carer's Allowance
Have you stopped receiving Carer's Allowance in the last three months? No

Your living arrangements

Do you rent and/or own the place where you are living? What are your living arrangements? Neither Parents

Savings, investments and other income

How have you supported yourself in the last 12 months? Do you have any National Savings Certificates? Family No

Apart from your main home, do you own any property or land in this country or abroad, even if it is on a mortgage? Does anyone owe you any money? Does anyone pay you rent for rooms or property? Do you get any payments from a credit insurance policy? Does anyone pay money to someone else on your behalf? Do you get any maintenance payments? Do you receive any other money from any source? Have you received any financial assistance towards the costs of a course of education which ended in the last three months or is still current?

No No No No No No No Yes

Savings, investments and other income - shareholdings

Do you own any shares? No

Capital
Do you have any of the following types of Bank account - savings? : Yes capital? Cash? : No Premium bonds? : No Bank account - current? : Yes National Savings account? : No Building society account? : No Post Office account? : No Unit trusts, ISAs, PEPs, TESSAs or other investments? : No Money from the sale of a house? : No Money saved for something? : No Money from a redundancy payment? : No Income bonds or capital bonds? : No Money or property held in trust - including any trusts set up for your child(ren)? : No Other savings? : No

About your capital: Bank Account - Savings

What is the value of this capital? 0

About your capital: Bank Account - Current

What is the value of this capital? 61.98

Personal injury payments

Do any of the savings and investments you have include a lump sum from any personal injury payment received by you within the last 52 weeks? No

Education subsidies
How many sources do you receive help with the cost of courses of education from, or expect to receive help with the cost of courses of education from? Are you in advanced education and entitled to claim a student loan? 0

No

About your Jobseeker's Allowance payments

Please provide details of the account into which you would like to receive Jobseeker's Allowance payments NATIONWIDE BLDG SCTY, MISS MY MOHAMOUD, ****1243, 070246

How you would like to get your Jobseeker's Allowance payments

How would you like to be paid Jobseeker's Allowance? Pay into account

Thank you for submitting your application

Your application for Jobseeker's Allowance (JSA) has been submitted You will no longer be able to view your application online. If you need to make any changes please contact Jobcentre Plus quoting your National Insurance Number. Jobcentre Plus (freephone): English: Welsh: Textphone: Monday to Friday 8.00 am to 6.00 pm 0800 055 6688 0800 012 1888 0800 023 4888

Next steps: application interview and assessment

We'll contact you by text or phone within two working days (Monday to Friday between 8.00 am and 6.00 pm) to arrange a 'new jobseeker interview' at your local Jobcentre Plus office. Your appointment may be on the same day. The interview will normally last between 20 to 40 minutes. If you and your partner are making a joint claim to income based Jobseeker's Allowance you must both attend the interview, which could last up to 1 hour.

What to bring to your interview

You'll need to check and sign your form at the interview. Please bring the following to the interview along with your CV, if you have one: A letter from the relevant Local Education Authority (or Authorities) confirming that they paid the course fees for your previous study For each source of help with the costs of education: evidence of the amount received, e.g. an award notice or bank/building society statements Two forms of identification for you, such as driving licence, passport, mortgage or rental agreement

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