{"id":1170,"date":"2024-12-04T10:21:09","date_gmt":"2024-12-04T10:21:09","guid":{"rendered":"https:\/\/partnershipone.com\/TDC\/?page_id=1170"},"modified":"2025-01-03T11:19:06","modified_gmt":"2025-01-03T11:19:06","slug":"council-tax-support","status":"publish","type":"page","link":"https:\/\/partnershipone.com\/TDC\/council-tax-support\/","title":{"rendered":"Apply for Council Tax Support"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of 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##00557E;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #000000;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(0, 85, 126, 0.8);}<\/style><div id='gf_13' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_13'  action='\/TDC\/wp-json\/wp\/v2\/pages\/1170#gf_13' data-formid='13' novalidate><div id='gf_page_steps_13' class='gf_page_steps'><div id='gf_step_13_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Using the form<\/span><\/div><div id='gf_step_13_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Declaration<\/span><\/div><div id='gf_step_13_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>About you<\/span><\/div><div id='gf_step_13_4' class='gf_step gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>About you (continued)<\/span><\/div><div id='gf_step_13_5' class='gf_step gf_step_pending'><span class='gf_step_number'>5<\/span><span class='gf_step_label'>About your living situation<\/span><\/div><div id='gf_step_13_6' class='gf_step gf_step_pending'><span class='gf_step_number'>6<\/span><span class='gf_step_label'>About your partner<\/span><\/div><div id='gf_step_13_7' class='gf_step gf_step_pending'><span class='gf_step_number'>7<\/span><span class='gf_step_label'>About any children who live with you<\/span><\/div><div id='gf_step_13_8' class='gf_step gf_step_pending'><span class='gf_step_number'>8<\/span><span class='gf_step_label'>About any other people who live with you<\/span><\/div><div id='gf_step_13_9' class='gf_step gf_step_pending'><span class='gf_step_number'>9<\/span><span class='gf_step_label'>About any benefits<\/span><\/div><div id='gf_step_13_10' class='gf_step gf_step_pending'><span class='gf_step_number'>10<\/span><span class='gf_step_label'>About any capital<\/span><\/div><div id='gf_step_13_11' class='gf_step gf_step_pending'><span class='gf_step_number'>11<\/span><span class='gf_step_label'>About the award start date<\/span><\/div><div id='gf_step_13_12' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>12<\/span><span class='gf_step_label'>About any proof and other information<\/span><\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_13_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_13' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_24\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >This form is to apply for Council Tax Support. \n<p><\/p>\nAnyone can apply for help with council tax but you will only get help if you have a low income. \n<p><\/p>\n It is important to provide accurate details of your income and capital so that the correct award of Council Tax Support can be made. \n<p><\/p>\nYou can ask for your claim to be backdated by up to three months. If you want to do this you&#8217;ll need to provide evidence when you apply showing your income and personal circumstances during the period you want it backdated to.\n<p><\/p>\n<strong>Capital limits <\/strong><br>\nIf your capital is above the amount below you will not be entitled to any Council Tax Support. \n<p><ul style=\"list-style-type:disc\">\n  <li>If you are working age, or treated as being working age the capital limit is \u00a36,000. <\/li>\n  <li>If you are pension age, the capital limit is \u00a316,000. <\/li>\n<\/ul><\/p>\n<\/p>\n <p><h3>This form will ask you to provide<\/h3><\/p>\n<p><ul style=\"list-style-type:disc\">\n  <li>your details including National Insurance number<\/li>\n  <li>details of any adults or children who normally live with you<\/li>\n  <li>details of any benefits and other income you receive<\/li>\n  <li>details of your capital<\/li>\n  <li>proof to support your application for example, proof of identity, proof of National Insurance number<\/li>\n<\/ul><\/p>\n\n<p>Please have this information ready as pages time-out after one hour.<\/p>\n\n<p>Do not use your browser back button &#8211; if you need to go to a previous page click on the previous button at the bottom of each page.<\/p>\n\n<h4>Privacy Statement<\/h4>\n\n<p>To provide this service Thanet District Council will collect and process personal information. We may check some of the information with other sources (e.g. government departments and other councils) to verify your identity and ensure that the information you have provided is accurate.<\/p>\n\n<p>Your personal information is being processed because it is necessary for compliance with a legal obligation or for the performance of a task carried out in the public interest.<\/p>\n\n<p>Please refer to our&nbsp;<a href=\"https:\/\/www.thanet.gov.uk\/privacy-statement\/\" target=\"_blank\">Corporate Privacy Notice<\/a>&nbsp;for further details on how we process your personal information and your rights. This is also available in other formats (e.g. print).<\/p>\n<\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_13_26' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Begin form'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_2' class='gform_page' data-js='page-field-id-26' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_2' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_514\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Declaration<\/h3><\/div><fieldset id=\"field_13_52\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you filling in this form for you or on behalf of someone else?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_52'>\n\t\t\t<div class='gchoice gchoice_13_52_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='I am filling in this form for me'  id='choice_13_52_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_52_0' id='label_13_52_0' class='gform-field-label gform-field-label--type-inline'>I am filling in this form for me<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_52_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='I am filling in this form on behalf of someone else'  id='choice_13_52_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_52_1' id='label_13_52_1' class='gform-field-label gform-field-label--type-inline'>I am filling in this form on behalf of someone else<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_27\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><ul style=\"list-style-type:disc\">\nPlease check the box below to confirm that you have read, understand and agree to the following statements before completing this form:<p><\/p>\n\n  <li>I confirm the details I will give are correct and true.<\/li>\n  <li>I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me.\n<\/li>\n  <li>I agree that you will use the information I have provided to process my claim for Housing Benefit or Council Tax Support, or both. You may check some of the information with other sources as allowed by the law.<\/li>\n  <li>I understand that you may use any information I have provided in connection with this and any other claim for social security benefits that I have made or may make. You may give some information to other organisations, such as government departments, local authorities and private-sector companies such as banks and organisations that may lend me money, where the law allows this.<\/li>\n  <li>I know that I must tell you straight away in writing about any change in my circumstances which might affect my claim.<\/li>\n<\/ul>\n<\/div><div id=\"field_13_55\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_13_54\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><ul style=\"list-style-type:disc\">\nPlease check the box below to confirm that you have read, understand and agree to the following statements before completing this form:<p><\/p>\n\n  <li>As far as possible, I will confirm with the person claiming that the answers I will give on this form are correct and that the documents I will upload as proof are original copies and have not been edited in any way.\n<\/li>\n  <li>I understand that if I give information that is false this could lead to a penalty or legal proceedings being taken against me.\n<\/li>\n  <li>I understand my data may be shared with other departments as permitted by law.\n<\/li>\n<\/ul><\/div><div id=\"field_13_63\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_13_6\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Declaration<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_6.1' id='input_13_6_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_13_6_1' >I understand and accept the above declaration<\/label><input type='hidden' name='input_6.2' value='I understand and accept the above declaration' class='gform_hidden' \/><input type='hidden' name='input_6.3' value='20' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_13_62\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_13_62'>We will not be able to discuss the claim with the person who is completing the form on the claimant\u2019s behalf unless they provide written permission to do so, unless you are already an appointee, have lasting power of attorney or are a court appointed deputy.<\/div><\/div><div id=\"field_13_57\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_57'>I am filling in this form on behalf of<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_13_57' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_58\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_58'>As they cannot fill in the form because<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_13_58' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_207\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is the claimant aware that you are completing this form on their behalf?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_207'>\n\t\t\t<div class='gchoice gchoice_13_207_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_207' type='radio' value='Yes'  id='choice_13_207_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_207_0' id='label_13_207_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_207_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_207' type='radio' value='No'  id='choice_13_207_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_207_1' id='label_13_207_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_60\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_60'>Full name of the person completing this form<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_60' id='input_13_60' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_56\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_56'>Relationship to the person claiming<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_13_56' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_59\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_59'>Contact email address or phone number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_13_59'>We might need to contact you to check the information you&#8217;ve given us<\/div><div class='ginput_container ginput_container_text'><input name='input_59' id='input_13_59' type='text' value='' class='large'  aria-describedby=\"gfield_description_13_59\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_8' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_8' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_3' class='gform_page' data-js='page-field-id-8' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_3' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_208\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\">About Universal Credit<\/h3><\/div><fieldset id=\"field_13_198\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label' >Are you currently receiving Universal Credit?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_198'>\n\t\t\t<div class='gchoice gchoice_13_198_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_198' type='radio' value='Yes, I am currently receiving Universal Credit'  id='choice_13_198_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_198_0' id='label_13_198_0' class='gform-field-label gform-field-label--type-inline'>Yes, I am currently receiving Universal Credit<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_198_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_198' type='radio' value='No, I am not receiving Universal Credit'  id='choice_13_198_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_198_1' id='label_13_198_1' class='gform-field-label gform-field-label--type-inline'>No, I am not receiving Universal Credit<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_200\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\">Not receiving Universal Credit<\/h3><\/div><div id=\"field_13_201\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  >You need to apply for Council Tax Support.  <a href=\"https:\/\/www.thanet.gov.uk\/info-pages\/council-tax-support\/\">Make a claim for Council Tax Support<\/a>\n<\/div><div id=\"field_13_167\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About you (the claimant)<\/h3><\/div><div id=\"field_13_542\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_542'>Benefit reference number<\/label><div class='ginput_container ginput_container_text'><input name='input_542' id='input_13_542' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_44\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_44'>Title (for example Mr, Mrs, Ms, Miss)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_44' id='input_13_44' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_45\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_45'>First name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_13_45' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_46\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_46'>Last name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_13_46' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_51'>Contact phone number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_13_51'>Please provide a mobile number if you have one as we are now using text messaging (SMS) to contact some of our residents.<\/div><div class='ginput_container ginput_container_text'><input name='input_51' id='input_13_51' type='text' value='' class='large'  aria-describedby=\"gfield_description_13_51\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_11\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Email address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_11'>We will use your email address to send the receipt of your form, including the form reference number. This may include personal data. We will also use your email address to contact you about your Council Tax account and\/or benefits.<\/div><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_13_11_container'>\n                                <span id='input_13_11_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_13_11' class='gform-field-label gform-field-label--type-sub '>Enter email address<\/label>\n                                    <input class='' type='email' name='input_11' id='input_13_11' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_13_11\" \/>\n                                <\/span>\n                                <span id='input_13_11_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_13_11_2' class='gform-field-label gform-field-label--type-sub '>Confirm email address<\/label>\n                                    <input class='' type='email' name='input_11_2' id='input_13_11_2' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_13_11\" \/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_13_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you like to receive your Council Tax bills by email?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_13'>You can receive your Council Tax bills and benefit notifications by email rather than post. We will send all future Council Tax bills and benefit notifications to the email address you have given above. This service is only available to people who are named on the bill. If you change your email address you must let us know straight away. You can opt out of this at any time at thanet.gov.uk\/paperless.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_13'>\n\t\t\t<div class='gchoice gchoice_13_13_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='Yes'  id='choice_13_13_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_13\"   \/>\n\t\t\t\t\t<label for='choice_13_13_0' id='label_13_13_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_13_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='No'  id='choice_13_13_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_13_1' id='label_13_13_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_66\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_66' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_66_2_container'><label for='input_13_66_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_66[]' id='input_13_66_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_66_1_container'><label for='input_13_66_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_66[]' id='input_13_66_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_66_3_container'><label for='input_13_66_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_66[]' id='input_13_66_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_65\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_65'>National Insurance number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_65' id='input_13_65' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_203\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_203'>Nationality<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_203' id='input_13_203' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_115\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your address<\/h3><\/div><fieldset id=\"field_13_169\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_169'>If you are renting a room include the room number<\/div>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_state has_zip ginput_container_address gform-grid-row' id='input_13_169' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_13_169_1_container' >\n                                        <label for='input_13_169_1' id='input_13_169_1_label' class='gform-field-label gform-field-label--type-sub '>Address line 1<\/label>\n                                        <input type='text' name='input_169.1' id='input_13_169_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_13_169_2_container' >\n                                        <label for='input_13_169_2' id='input_13_169_2_label' class='gform-field-label gform-field-label--type-sub '>Address line 2<\/label>\n                                        <input type='text' name='input_169.2' id='input_13_169_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_13_169_4_container' >\n                                        <label for='input_13_169_4' id='input_13_169_4_label' class='gform-field-label gform-field-label--type-sub '>Town or city<\/label>\n                                        <input type='text' name='input_169.4' id='input_13_169_4' value=''      aria-required='true'    \/>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_13_169_5_container' >\n                                    <label for='input_13_169_5' id='input_13_169_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                    <input type='text' name='input_169.5' id='input_13_169_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_169.6' id='input_13_169_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_13_441\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What date did you move into this address?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_441' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_441_2_container'><label for='input_13_441_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_441[]' id='input_13_441_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_441_1_container'><label for='input_13_441_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_441[]' id='input_13_441_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_441_3_container'><label for='input_13_441_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_441[]' id='input_13_441_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_218' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_218' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_4' class='gform_page' data-js='page-field-id-218' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_4' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_219\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About you (the claimant) continued<\/h3><\/div><fieldset id=\"field_13_232\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you a full time student?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_232'>\n\t\t\t<div class='gchoice gchoice_13_232_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_232' type='radio' value='Yes'  id='choice_13_232_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_232_0' id='label_13_232_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_232_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_232' type='radio' value='No'  id='choice_13_232_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_232_1' id='label_13_232_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_233\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you already provided a copy of your student certificate?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_233'>\n\t\t\t<div class='gchoice gchoice_13_233_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_233' type='radio' value='Yes'  id='choice_13_233_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_233_0' id='label_13_233_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_233_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_233' type='radio' value='No'  id='choice_13_233_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_233_1' id='label_13_233_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_234\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_13_234'>Upload a copy of your  current student certificate<\/label><div class='gfield_description' id='gfield_description_13_234'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_13_234' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_13_234&quot;,&quot;container&quot;:&quot;gform_multifile_upload_13_234&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_13_234&quot;,&quot;filelist&quot;:&quot;gform_preview_13_234&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;txt,pdf,doc,docx,rtf,jpg,jpeg,tif,tiff,bmp,png,xls,xlsx&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:13,&quot;field_id&quot;:234,&quot;_gform_file_upload_nonce_13_234&quot;:&quot;0ac9c095c9&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_13_234&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_13_234' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_13_234' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_13_234 gfield_description_13_234\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_13_234'>Accepted file types: txt, pdf, doc, docx, rtf, jpg, jpeg, tif, tiff, bmp, png, xls, xlsx, Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_13_234'><\/ul> <div id='gform_preview_13_234' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_13_235\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you an apprentice?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_235'>If you or someone living with you is an apprentice, and without them there is only one adult living in your home, you can apply for an <a href=\"https:\/\/www.thanet.gov.uk\/info-pages\/council-tax-discounts-and-exemptions\/?question=850-2\" target=\"_blank\">apprentice discount<\/a>.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_235'>\n\t\t\t<div class='gchoice gchoice_13_235_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_235' type='radio' value='Yes'  id='choice_13_235_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_235\"   \/>\n\t\t\t\t\t<label for='choice_13_235_0' id='label_13_235_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_235_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_235' type='radio' value='No'  id='choice_13_235_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_235_1' id='label_13_235_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_549\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you a Kent County Council Care Leaver and receive assistance by the &#039;Local Offer for Care Leavers&#039;?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_549'>\n\t\t\t<div class='gchoice gchoice_13_549_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_549' type='radio' value='Yes'  id='choice_13_549_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_549_0' id='label_13_549_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_549_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_549' type='radio' value='No'  id='choice_13_549_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_549_1' id='label_13_549_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_237\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you severely mentally impaired?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_237'>If everyone living in a property is severely mentally impaired you can apply for an exemption (which means you don\u2019t have to pay Council Tax for the property).  If someone living with you is severely mentally impaired and without them there is only one adult living in your home, you can apply for a 25% discount on your Council Tax.   \nYou can apply for a <a href=\"https:\/\/www.thanet.gov.uk\/info-pages\/council-tax-discounts-and-exemptions\/?question=850-18\" target=\"_blank\">severely mentally impaired discount or exemption<\/a>.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_237'>\n\t\t\t<div class='gchoice gchoice_13_237_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_237' type='radio' value='Yes'  id='choice_13_237_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_237\"   \/>\n\t\t\t\t\t<label for='choice_13_237_0' id='label_13_237_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_237_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_237' type='radio' value='No'  id='choice_13_237_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_237_1' id='label_13_237_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_239\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you registered blind?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_239'>\n\t\t\t<div class='gchoice gchoice_13_239_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_239' type='radio' value='Yes'  id='choice_13_239_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_239_0' id='label_13_239_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_239_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_239' type='radio' value='No'  id='choice_13_239_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_239_1' id='label_13_239_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_240\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does anyone get Carer&#039;s Allowance or the carer&#039;s element of Universal Credit for looking after you?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_240'>\n\t\t\t<div class='gchoice gchoice_13_240_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_240' type='radio' value='Yes'  id='choice_13_240_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_240_0' id='label_13_240_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_240_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_240' type='radio' value='No'  id='choice_13_240_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_240_1' id='label_13_240_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_241\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you temporarily living away from home?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_241'>\n\t\t\t<div class='gchoice gchoice_13_241_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_241' type='radio' value='Yes'  id='choice_13_241_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_241_0' id='label_13_241_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_241_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_241' type='radio' value='No'  id='choice_13_241_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_241_1' id='label_13_241_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_242\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >When did you start living away from home?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_242' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_242_2_container'><label for='input_13_242_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_242[]' id='input_13_242_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_242_1_container'><label for='input_13_242_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_242[]' id='input_13_242_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_242_3_container'><label for='input_13_242_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_242[]' id='input_13_242_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_243\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_243'>Where are you temporarily living and why?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_13_243'>Such as hospital, on remand, if abroad specify the country you are visiting<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_243' id='input_13_243' class='textarea small'  aria-describedby=\"gfield_description_13_243\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_13_244\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_244'>When do you expect to return home?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_244' id='input_13_244' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_64' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_64' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_5' class='gform_page' data-js='page-field-id-64' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_5' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_67\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your living situation<\/h3><\/div><fieldset id=\"field_13_72\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you live on your own?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_72'>If you have a partner, children or any other adult living in your household, answer No to this question.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_72'>\n\t\t\t<div class='gchoice gchoice_13_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Yes'  id='choice_13_72_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_72\"   \/>\n\t\t\t\t\t<label for='choice_13_72_0' id='label_13_72_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='No'  id='choice_13_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_72_1' id='label_13_72_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_286\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_13_211\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have a partner living with you?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_211'>By partner we mean a person you are married to or a person you live with as if you are married to them or a civil partner or a person you live with as if you are civil partners.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_211'>\n\t\t\t<div class='gchoice gchoice_13_211_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_211' type='radio' value='Yes'  id='choice_13_211_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_211\"   \/>\n\t\t\t\t\t<label for='choice_13_211_0' id='label_13_211_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_211_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_211' type='radio' value='No'  id='choice_13_211_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_211_1' id='label_13_211_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_260\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_13_216\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have any children who normally live with you?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_216'>A child for this question is any child you are or could receive Child Benefit for. So they would be aged under 16, aged 16 or 17 and registered for work or youth training or aged 16 to 19 and in education on a course not higher than GCE A-Level, SCE Higher Level, or GNVQ advanced.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_216'>\n\t\t\t<div class='gchoice gchoice_13_216_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_216' type='radio' value='Yes'  id='choice_13_216_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_216\"   \/>\n\t\t\t\t\t<label for='choice_13_216_0' id='label_13_216_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_216_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_216' type='radio' value='No'  id='choice_13_216_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_216_1' id='label_13_216_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_285\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_13_213\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have any other people who live with you (other than your partner if you have one)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_213'>An adult is anyone over the age of 16 that you do not receive Child Benefit for. This includes other family and friends, boarders, subtenants and lodgers. Include any children they have who live in your household.  Don\u2019t tell us about people who just share a hall, bathroom and\/or toilet.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_213'>\n\t\t\t<div class='gchoice gchoice_13_213_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Yes'  id='choice_13_213_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_213\"   \/>\n\t\t\t\t\t<label for='choice_13_213_0' id='label_13_213_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_213_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='No'  id='choice_13_213_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_213_1' id='label_13_213_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_323' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_323' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_6' class='gform_page' data-js='page-field-id-323' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_6' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_217\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About your partner who lives with you<\/h3><div class='gsection_description' id='gfield_description_13_217'>By partner we mean:\n<ul style=\"list-style-type:disc\">\n  <li>a person you are married to or a person you live with as if you are married to them or<\/li>\n  <li> a civil partner or a person you live with as if you are civil partners<\/li>\n<\/ul>\n\nPlease provide the following information about your partner:\n<\/div><\/div><div id=\"field_13_227\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_227'>Title (for example Mr, Mrs, Ms, Miss) (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_227' id='input_13_227' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_228\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_228'>First name (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_228' id='input_13_228' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_229\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_229'>Last name (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_229' id='input_13_229' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_220\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_220'>Contact phone number (partner)<\/label><div class='ginput_container ginput_container_text'><input name='input_220' id='input_13_220' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_221\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Email address (partner)<\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_13_221_container'>\n                                <span id='input_13_221_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_13_221' class='gform-field-label gform-field-label--type-sub '>Enter email address<\/label>\n                                    <input class='' type='email' name='input_221' id='input_13_221' value=''     aria-invalid=\"false\"  \/>\n                                <\/span>\n                                <span id='input_13_221_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_13_221_2' class='gform-field-label gform-field-label--type-sub '>Confirm email address<\/label>\n                                    <input class='' type='email' name='input_221_2' id='input_13_221_2' value=''     aria-invalid=\"false\"  \/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_13_224\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_224' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_224_2_container'><label for='input_13_224_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_224[]' id='input_13_224_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_224_1_container'><label for='input_13_224_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_224[]' id='input_13_224_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_224_3_container'><label for='input_13_224_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_224[]' id='input_13_224_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_223\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_223'>National Insurance number (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_223' id='input_13_223' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_225\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_225'>Nationality (partner)<\/label><div class='ginput_container ginput_container_text'><input name='input_225' id='input_13_225' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_245\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a full time student? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_245'>\n\t\t\t<div class='gchoice gchoice_13_245_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_245' type='radio' value='Yes'  id='choice_13_245_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_245_0' id='label_13_245_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_245_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_245' type='radio' value='No'  id='choice_13_245_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_245_1' id='label_13_245_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_246\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have they already provided a copy of their student certificate? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_246'>\n\t\t\t<div class='gchoice gchoice_13_246_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_246' type='radio' value='Yes'  id='choice_13_246_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_246_0' id='label_13_246_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_246_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_246' type='radio' value='No'  id='choice_13_246_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_246_1' id='label_13_246_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_247\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_13_247'>Upload a copy of their current student certificate (partner)<\/label><div class='gfield_description' id='gfield_description_13_247'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_13_247' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_13_247&quot;,&quot;container&quot;:&quot;gform_multifile_upload_13_247&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_13_247&quot;,&quot;filelist&quot;:&quot;gform_preview_13_247&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;txt,pdf,doc,docx,rtf,jpg,jpeg,tif,tiff,bmp,png,xls,xlsx&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:13,&quot;field_id&quot;:247,&quot;_gform_file_upload_nonce_13_247&quot;:&quot;1fc7164cee&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_13_247&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_13_247' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_13_247' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_13_247 gfield_description_13_247\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_13_247'>Accepted file types: txt, pdf, doc, docx, rtf, jpg, jpeg, tif, tiff, bmp, png, xls, xlsx, Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_13_247'><\/ul> <div id='gform_preview_13_247' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_13_248\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they an apprentice? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_248'>If you or someone living with you is an apprentice, and without them there is only one adult living in your home, you can apply for an <a href=\"https:\/\/www.thanet.gov.uk\/info-pages\/council-tax-discounts-and-exemptions\/?question=850-2\" target=\"_blank\">apprentice discount<\/a>.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_248'>\n\t\t\t<div class='gchoice gchoice_13_248_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_248' type='radio' value='Yes'  id='choice_13_248_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_248\"   \/>\n\t\t\t\t\t<label for='choice_13_248_0' id='label_13_248_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_248_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_248' type='radio' value='No'  id='choice_13_248_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_248_1' id='label_13_248_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_250\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they severely mentally impaired? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_250'>If everyone living in a property is severely mentally impaired you can apply for an exemption (which means you don\u2019t have to pay Council Tax for the property).  If someone living with you is severely mentally impaired and without them there is only one adult living in your home, you can apply for a 25% discount on your Council Tax.  \nYou can apply for a <a href=\"https:\/\/www.thanet.gov.uk\/info-pages\/council-tax-discounts-and-exemptions\/?question=850-18\" target=\"_blank\">severely mentally impaired discount or exemption<\/a>.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_250'>\n\t\t\t<div class='gchoice gchoice_13_250_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_250' type='radio' value='Yes'  id='choice_13_250_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_250\"   \/>\n\t\t\t\t\t<label for='choice_13_250_0' id='label_13_250_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_250_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_250' type='radio' value='No'  id='choice_13_250_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_250_1' id='label_13_250_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_252\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they registered blind? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_252'>\n\t\t\t<div class='gchoice gchoice_13_252_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_252' type='radio' value='Yes'  id='choice_13_252_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_252_0' id='label_13_252_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_252_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_252' type='radio' value='No'  id='choice_13_252_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_252_1' id='label_13_252_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_442\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does anyone get Carer&#039;s Allowance or the carer&#039;s element of Universal Credit for looking after your partner?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_442'>\n\t\t\t<div class='gchoice gchoice_13_442_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_442' type='radio' value='Yes'  id='choice_13_442_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_442_0' id='label_13_442_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_442_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_442' type='radio' value='No'  id='choice_13_442_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_442_1' id='label_13_442_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_253\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they temporarily living away from home? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_253'>\n\t\t\t<div class='gchoice gchoice_13_253_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_253' type='radio' value='Yes'  id='choice_13_253_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_253_0' id='label_13_253_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_253_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_253' type='radio' value='No'  id='choice_13_253_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_253_1' id='label_13_253_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_256\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >When did they start living away from home? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_256' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_256_2_container'><label for='input_13_256_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_256[]' id='input_13_256_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_256_1_container'><label for='input_13_256_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_256[]' id='input_13_256_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_256_3_container'><label for='input_13_256_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_256[]' id='input_13_256_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_257\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_257'>Where are they temporarily living and why? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_13_257'>Such as hospital, on remand, if abroad specify the country they are visiting.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_257' id='input_13_257' class='textarea small'  aria-describedby=\"gfield_description_13_257\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_13_258\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_258'>When do you expect them to return home? (partner)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_258' id='input_13_258' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_271' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_271' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_7' class='gform_page' data-js='page-field-id-271' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_7' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_230\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the children who live with you<\/h3><div class='gsection_description' id='gfield_description_13_230'>We need to know about any children who normally live with you and\/or who you or your partner get, or have applied for, Child Benefit for.\n<p><\/p>\n<p><\/p>\nA child is:\n<ul style=\"list-style-type:disc\">\n  <li>aged under 16<\/li>\n  <li> aged 16 or 17 and registered for work or youth training, or<\/li>\n  <li>aged 16 to 19 and in education on a course not higher than GCE A-Level, SCE Higher Level, or GNVQ advanced<\/li>\n<\/ul>\n\n<\/div><\/div><div id=\"field_13_284\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the first child<\/h3><\/div><div id=\"field_13_262\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_262'>Full name (child 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_262' id='input_13_262' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_263\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_263' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_263_2_container'><label for='input_13_263_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_263[]' id='input_13_263_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_263_1_container'><label for='input_13_263_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_263[]' id='input_13_263_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_263_3_container'><label for='input_13_263_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_263[]' id='input_13_263_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_264\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_264'>Gender (child 1)<\/label><div class='ginput_container ginput_container_text'><input name='input_264' id='input_13_264' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_265\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_265'>\n\t\t\t<div class='gchoice gchoice_13_265_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_265' type='radio' value='Yes'  id='choice_13_265_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_265_0' id='label_13_265_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_265_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_265' type='radio' value='No'  id='choice_13_265_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_265_1' id='label_13_265_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_315\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_315'>How much Child Benefit do you receive for this child? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_315' id='input_13_315' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_443\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_443'>\n\t\t\t<div class='gchoice gchoice_13_443_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_443' type='radio' value='Yes'  id='choice_13_443_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_443_0' id='label_13_443_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_443_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_443' type='radio' value='No'  id='choice_13_443_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_443_1' id='label_13_443_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_446\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (1)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (1)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends with them each week (1)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_446_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (1)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (1), Row 1' data-aria-label-template='Name of the person receiving the child benefit (1), Row {0}' type='text' name='input_446[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_446_cell2 gform-grid-col' data-label='Relationship to this child (1)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (1), Row 1' data-aria-label-template='Relationship to this child (1), Row {0}' type='text' name='input_446[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_446_cell3 gform-grid-col' data-label='Number of hours this child spends with them each week (1)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends with them each week (1), Row 1' data-aria-label-template='Number of hours this child spends with them each week (1), Row {0}' type='text' name='input_446[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_266\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_266'>\n\t\t\t<div class='gchoice gchoice_13_266_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_266' type='radio' value='Yes'  id='choice_13_266_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_266_0' id='label_13_266_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_266_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_266' type='radio' value='No'  id='choice_13_266_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_266_1' id='label_13_266_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_267\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_267'>\n\t\t\t<div class='gchoice gchoice_13_267_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_267' type='radio' value='Yes'  id='choice_13_267_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_267_0' id='label_13_267_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_267_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_267' type='radio' value='No'  id='choice_13_267_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_267_1' id='label_13_267_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_269\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_269'>\n\t\t\t<div class='gchoice gchoice_13_269_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_269' type='radio' value='Yes'  id='choice_13_269_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_269_0' id='label_13_269_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_269_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_269' type='radio' value='No'  id='choice_13_269_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_269_1' id='label_13_269_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_268\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_268'>What benefit(s) does this child receive? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_268' id='input_13_268' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_13_270\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_270'>What is their National Insurance number? (1)<\/label><div class='ginput_container ginput_container_text'><input name='input_270' id='input_13_270' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_543\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner pay any childminding costs for this child to a registered childminder, a nursery or an after-school club? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_543'>If \u2018Yes\u2019 we may need additional evidence about this depending on your other circumstances<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_543'>\n\t\t\t<div class='gchoice gchoice_13_543_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_543' type='radio' value='Yes'  id='choice_13_543_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_543\"   \/>\n\t\t\t\t\t<label for='choice_13_543_0' id='label_13_543_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_543_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_543' type='radio' value='No'  id='choice_13_543_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_543_1' id='label_13_543_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_272\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_272'>\n\t\t\t<div class='gchoice gchoice_13_272_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_272' type='radio' value='Yes'  id='choice_13_272_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_272_0' id='label_13_272_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_272_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_272' type='radio' value='No'  id='choice_13_272_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_272_1' id='label_13_272_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_273\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the second child<\/h3><\/div><div id=\"field_13_325\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_325'>Full name (child 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_325' id='input_13_325' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_326\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_326' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_326_2_container'><label for='input_13_326_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_326[]' id='input_13_326_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_326_1_container'><label for='input_13_326_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_326[]' id='input_13_326_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_326_3_container'><label for='input_13_326_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_326[]' id='input_13_326_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_327\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_327'>Gender (child 2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_327' id='input_13_327' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_330\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_330'>\n\t\t\t<div class='gchoice gchoice_13_330_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_330' type='radio' value='Yes'  id='choice_13_330_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_330_0' id='label_13_330_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_330_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_330' type='radio' value='No'  id='choice_13_330_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_330_1' id='label_13_330_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_331\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_331'>How much Child Benefit do you receive for this child? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_331' id='input_13_331' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_445\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_445'>\n\t\t\t<div class='gchoice gchoice_13_445_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_445' type='radio' value='Yes'  id='choice_13_445_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_445_0' id='label_13_445_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_445_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_445' type='radio' value='No'  id='choice_13_445_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_445_1' id='label_13_445_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_444\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (2)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (2)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends with them each week (2)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_444_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (2)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (2), Row 1' data-aria-label-template='Name of the person receiving the child benefit (2), Row {0}' type='text' name='input_444[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_444_cell2 gform-grid-col' data-label='Relationship to this child (2)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (2), Row 1' data-aria-label-template='Relationship to this child (2), Row {0}' type='text' name='input_444[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_444_cell3 gform-grid-col' data-label='Number of hours this child spends with them each week (2)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends with them each week (2), Row 1' data-aria-label-template='Number of hours this child spends with them each week (2), Row {0}' type='text' name='input_444[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_332\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_332'>\n\t\t\t<div class='gchoice gchoice_13_332_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_332' type='radio' value='Yes'  id='choice_13_332_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_332_0' id='label_13_332_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_332_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_332' type='radio' value='No'  id='choice_13_332_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_332_1' id='label_13_332_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_333\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_333'>\n\t\t\t<div class='gchoice gchoice_13_333_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_333' type='radio' value='Yes'  id='choice_13_333_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_333_0' id='label_13_333_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_333_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_333' type='radio' value='No'  id='choice_13_333_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_333_1' id='label_13_333_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_334\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_334'>\n\t\t\t<div class='gchoice gchoice_13_334_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_334' type='radio' value='Yes'  id='choice_13_334_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_334_0' id='label_13_334_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_334_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_334' type='radio' value='No'  id='choice_13_334_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_334_1' id='label_13_334_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_328\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_328'>What benefit(s) does this child receive? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_328' id='input_13_328' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_13_329\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_329'>What is their National Insurance number? (2)<\/label><div class='ginput_container ginput_container_text'><input name='input_329' id='input_13_329' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_544\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner pay any childminding costs for this child to a registered childminder, a nursery or an after-school club? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_544'>If \u2018Yes\u2019 we may need additional evidence about this depending on your other circumstances<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_544'>\n\t\t\t<div class='gchoice gchoice_13_544_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_544' type='radio' value='Yes'  id='choice_13_544_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_544\"   \/>\n\t\t\t\t\t<label for='choice_13_544_0' id='label_13_544_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_544_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_544' type='radio' value='No'  id='choice_13_544_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_544_1' id='label_13_544_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_274\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_274'>\n\t\t\t<div class='gchoice gchoice_13_274_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_274' type='radio' value='Yes'  id='choice_13_274_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_274_0' id='label_13_274_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_274_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_274' type='radio' value='No'  id='choice_13_274_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_274_1' id='label_13_274_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_275\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the third child<\/h3><\/div><div id=\"field_13_345\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_345'>Full name (child 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_345' id='input_13_345' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_344\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_344' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_344_2_container'><label for='input_13_344_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_344[]' id='input_13_344_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_344_1_container'><label for='input_13_344_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_344[]' id='input_13_344_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_344_3_container'><label for='input_13_344_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_344[]' id='input_13_344_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_343\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_343'>Gender (child 3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_343' id='input_13_343' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_342\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_342'>\n\t\t\t<div class='gchoice gchoice_13_342_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_342' type='radio' value='Yes'  id='choice_13_342_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_342_0' id='label_13_342_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_342_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_342' type='radio' value='No'  id='choice_13_342_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_342_1' id='label_13_342_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_341\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_341'>How much Child Benefit do you receive for this child? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_341' id='input_13_341' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_447\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_447'>\n\t\t\t<div class='gchoice gchoice_13_447_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_447' type='radio' value='Yes'  id='choice_13_447_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_447_0' id='label_13_447_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_447_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_447' type='radio' value='No'  id='choice_13_447_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_447_1' id='label_13_447_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_448\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (3)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (3)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends with them each week (3)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_448_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (3)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (3), Row 1' data-aria-label-template='Name of the person receiving the child benefit (3), Row {0}' type='text' name='input_448[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_448_cell2 gform-grid-col' data-label='Relationship to this child (3)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (3), Row 1' data-aria-label-template='Relationship to this child (3), Row {0}' type='text' name='input_448[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_448_cell3 gform-grid-col' data-label='Number of hours this child spends with them each week (3)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends with them each week (3), Row 1' data-aria-label-template='Number of hours this child spends with them each week (3), Row {0}' type='text' name='input_448[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_340\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_340'>\n\t\t\t<div class='gchoice gchoice_13_340_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_340' type='radio' value='Yes'  id='choice_13_340_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_340_0' id='label_13_340_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_340_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_340' type='radio' value='No'  id='choice_13_340_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_340_1' id='label_13_340_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_339\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_339'>\n\t\t\t<div class='gchoice gchoice_13_339_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_339' type='radio' value='Yes'  id='choice_13_339_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_339_0' id='label_13_339_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_339_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_339' type='radio' value='No'  id='choice_13_339_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_339_1' id='label_13_339_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_338\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_338'>\n\t\t\t<div class='gchoice gchoice_13_338_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_338' type='radio' value='Yes'  id='choice_13_338_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_338_0' id='label_13_338_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_338_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_338' type='radio' value='No'  id='choice_13_338_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_338_1' id='label_13_338_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_336\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_336'>What benefit(s) does this child receive? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_336' id='input_13_336' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_13_335\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_335'>What is their National Insurance number? (3)<\/label><div class='ginput_container ginput_container_text'><input name='input_335' id='input_13_335' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_545\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner pay any childminding costs for this child to a registered childminder, a nursery or an after-school club? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_545'>If \u2018Yes\u2019 we may need additional evidence about this depending on your other circumstances<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_545'>\n\t\t\t<div class='gchoice gchoice_13_545_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_545' type='radio' value='Yes'  id='choice_13_545_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_545\"   \/>\n\t\t\t\t\t<label for='choice_13_545_0' id='label_13_545_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_545_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_545' type='radio' value='No'  id='choice_13_545_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_545_1' id='label_13_545_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_279\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_279'>\n\t\t\t<div class='gchoice gchoice_13_279_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_279' type='radio' value='Yes'  id='choice_13_279_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_279_0' id='label_13_279_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_279_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_279' type='radio' value='No'  id='choice_13_279_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_279_1' id='label_13_279_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_276\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the fourth child<\/h3><\/div><div id=\"field_13_346\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_346'>Full name (child 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_346' id='input_13_346' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_372\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_372' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_372_2_container'><label for='input_13_372_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_372[]' id='input_13_372_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_372_1_container'><label for='input_13_372_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_372[]' id='input_13_372_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_372_3_container'><label for='input_13_372_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_372[]' id='input_13_372_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_369\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_369'>Gender (child 4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_369' id='input_13_369' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_365\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_365'>\n\t\t\t<div class='gchoice gchoice_13_365_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_365' type='radio' value='Yes'  id='choice_13_365_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_365_0' id='label_13_365_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_365_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_365' type='radio' value='No'  id='choice_13_365_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_365_1' id='label_13_365_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_362\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_362'>How much Child Benefit do you receive for this child? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_362' id='input_13_362' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_449\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_449'>\n\t\t\t<div class='gchoice gchoice_13_449_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_449' type='radio' value='Yes'  id='choice_13_449_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_449_0' id='label_13_449_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_449_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_449' type='radio' value='No'  id='choice_13_449_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_449_1' id='label_13_449_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_450\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (4)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (4)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends (4)with them each week (4)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_450_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (4)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (4), Row 1' data-aria-label-template='Name of the person receiving the child benefit (4), Row {0}' type='text' name='input_450[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_450_cell2 gform-grid-col' data-label='Relationship to this child (4)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (4), Row 1' data-aria-label-template='Relationship to this child (4), Row {0}' type='text' name='input_450[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_450_cell3 gform-grid-col' data-label='Number of hours this child spends (4)with them each week (4)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends (4)with them each week (4), Row 1' data-aria-label-template='Number of hours this child spends (4)with them each week (4), Row {0}' type='text' name='input_450[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_359\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_359'>\n\t\t\t<div class='gchoice gchoice_13_359_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_359' type='radio' value='Yes'  id='choice_13_359_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_359_0' id='label_13_359_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_359_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_359' type='radio' value='No'  id='choice_13_359_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_359_1' id='label_13_359_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_356\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_356'>\n\t\t\t<div class='gchoice gchoice_13_356_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_356' type='radio' value='Yes'  id='choice_13_356_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_356_0' id='label_13_356_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_356_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_356' type='radio' value='No'  id='choice_13_356_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_356_1' id='label_13_356_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_349\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_349'>\n\t\t\t<div class='gchoice gchoice_13_349_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_349' type='radio' value='Yes'  id='choice_13_349_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_349_0' id='label_13_349_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_349_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_349' type='radio' value='No'  id='choice_13_349_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_349_1' id='label_13_349_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_348\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_348'>What benefit(s) does this child receive? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_348' id='input_13_348' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_13_347\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_347'>What is their National Insurance number? (4)<\/label><div class='ginput_container ginput_container_text'><input name='input_347' id='input_13_347' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_546\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner pay any childminding costs for this child to a registered childminder, a nursery or an after-school club? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_546'>If \u2018Yes\u2019 we may need additional evidence about this depending on your other circumstances<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_546'>\n\t\t\t<div class='gchoice gchoice_13_546_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_546' type='radio' value='Yes'  id='choice_13_546_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_546\"   \/>\n\t\t\t\t\t<label for='choice_13_546_0' id='label_13_546_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_546_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_546' type='radio' value='No'  id='choice_13_546_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_546_1' id='label_13_546_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_280\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_280'>\n\t\t\t<div class='gchoice gchoice_13_280_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_280' type='radio' value='Yes'  id='choice_13_280_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_280_0' id='label_13_280_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_280_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_280' type='radio' value='No'  id='choice_13_280_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_280_1' id='label_13_280_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_277\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the fifth child<\/h3><\/div><div id=\"field_13_375\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_375'>Full name (child 5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_375' id='input_13_375' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_373\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_373' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_373_2_container'><label for='input_13_373_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_373[]' id='input_13_373_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_373_1_container'><label for='input_13_373_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_373[]' id='input_13_373_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_373_3_container'><label for='input_13_373_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_373[]' id='input_13_373_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_370\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_370'>Gender (child 5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_370' id='input_13_370' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_366\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_366'>\n\t\t\t<div class='gchoice gchoice_13_366_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_366' type='radio' value='Yes'  id='choice_13_366_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_366_0' id='label_13_366_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_366_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_366' type='radio' value='No'  id='choice_13_366_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_366_1' id='label_13_366_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_363\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_363'>How much Child Benefit do you receive for this child? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_363' id='input_13_363' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_453\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_453'>\n\t\t\t<div class='gchoice gchoice_13_453_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_453' type='radio' value='Yes'  id='choice_13_453_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_453_0' id='label_13_453_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_453_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_453' type='radio' value='No'  id='choice_13_453_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_453_1' id='label_13_453_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_452\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (5)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (5)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends with them each week (5)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_452_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (5)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (5), Row 1' data-aria-label-template='Name of the person receiving the child benefit (5), Row {0}' type='text' name='input_452[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_452_cell2 gform-grid-col' data-label='Relationship to this child (5)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (5), Row 1' data-aria-label-template='Relationship to this child (5), Row {0}' type='text' name='input_452[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_452_cell3 gform-grid-col' data-label='Number of hours this child spends with them each week (5)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends with them each week (5), Row 1' data-aria-label-template='Number of hours this child spends with them each week (5), Row {0}' type='text' name='input_452[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_360\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_360'>\n\t\t\t<div class='gchoice gchoice_13_360_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_360' type='radio' value='Yes'  id='choice_13_360_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_360_0' id='label_13_360_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_360_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_360' type='radio' value='No'  id='choice_13_360_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_360_1' id='label_13_360_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_357\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_357'>\n\t\t\t<div class='gchoice gchoice_13_357_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_357' type='radio' value='Yes'  id='choice_13_357_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_357_0' id='label_13_357_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_357_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_357' type='radio' value='No'  id='choice_13_357_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_357_1' id='label_13_357_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_354\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_354'>\n\t\t\t<div class='gchoice gchoice_13_354_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_354' type='radio' value='Yes'  id='choice_13_354_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_354_0' id='label_13_354_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_354_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_354' type='radio' value='No'  id='choice_13_354_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_354_1' id='label_13_354_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_352\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_352'>What benefit(s) does this child receive? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_352' id='input_13_352' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_13_351\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_351'>What is their National Insurance number? (5)<\/label><div class='ginput_container ginput_container_text'><input name='input_351' id='input_13_351' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_547\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner pay any childminding costs for this child to a registered childminder, a nursery or an after-school club? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_547'>If \u2018Yes\u2019 we may need additional evidence about this depending on your other circumstances<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_547'>\n\t\t\t<div class='gchoice gchoice_13_547_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_547' type='radio' value='Yes'  id='choice_13_547_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_547\"   \/>\n\t\t\t\t\t<label for='choice_13_547_0' id='label_13_547_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_547_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_547' type='radio' value='No'  id='choice_13_547_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_547_1' id='label_13_547_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_283\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? (5)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_283'>\n\t\t\t<div class='gchoice gchoice_13_283_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_283' type='radio' value='Yes'  id='choice_13_283_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_283_0' id='label_13_283_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_283_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_283' type='radio' value='No'  id='choice_13_283_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_283_1' id='label_13_283_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_281\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the sixth child<\/h3><\/div><div id=\"field_13_376\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_376'>Full name (child 6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_376' id='input_13_376' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_374\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (child 6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_374' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_374_2_container'><label for='input_13_374_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_374[]' id='input_13_374_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_374_1_container'><label for='input_13_374_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_374[]' id='input_13_374_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_374_3_container'><label for='input_13_374_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_374[]' id='input_13_374_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_371\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_371'>Gender (child 6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_371' id='input_13_371' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_368\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive Child Benefit for this child?  (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_368'>\n\t\t\t<div class='gchoice gchoice_13_368_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_368' type='radio' value='Yes'  id='choice_13_368_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_368_0' id='label_13_368_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_368_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_368' type='radio' value='No'  id='choice_13_368_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_368_1' id='label_13_368_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_364\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_364'>How much Child Benefit do you receive for this child? (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_364' id='input_13_364' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_451\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you applied for Child Benefit for this child? (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_451'>\n\t\t\t<div class='gchoice gchoice_13_451_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_451' type='radio' value='Yes'  id='choice_13_451_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_451_0' id='label_13_451_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_451_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_451' type='radio' value='No'  id='choice_13_451_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_451_1' id='label_13_451_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_467\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Who receives child benefit for this child? (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the person receiving the child benefit (6)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to this child (6)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of hours this child spends with them each week (6)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_467_cell1 gform-grid-col' data-label='Name of the person receiving the child benefit (6)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of the person receiving the child benefit (6), Row 1' data-aria-label-template='Name of the person receiving the child benefit (6), Row {0}' type='text' name='input_467[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_467_cell2 gform-grid-col' data-label='Relationship to this child (6)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Relationship to this child (6), Row 1' data-aria-label-template='Relationship to this child (6), Row {0}' type='text' name='input_467[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_467_cell3 gform-grid-col' data-label='Number of hours this child spends with them each week (6)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of hours this child spends with them each week (6), Row 1' data-aria-label-template='Number of hours this child spends with them each week (6), Row {0}' type='text' name='input_467[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_361\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this child registered blind? (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_361'>\n\t\t\t<div class='gchoice gchoice_13_361_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_361' type='radio' value='Yes'  id='choice_13_361_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_361_0' id='label_13_361_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_361_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_361' type='radio' value='No'  id='choice_13_361_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_361_1' id='label_13_361_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_358\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has this child been formally placed with you for fostering? (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_358'>\n\t\t\t<div class='gchoice gchoice_13_358_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_358' type='radio' value='Yes'  id='choice_13_358_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_358_0' id='label_13_358_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_358_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_358' type='radio' value='No'  id='choice_13_358_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_358_1' id='label_13_358_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_355\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_355'>\n\t\t\t<div class='gchoice gchoice_13_355_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_355' type='radio' value='Yes'  id='choice_13_355_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_355_0' id='label_13_355_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_355_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_355' type='radio' value='No'  id='choice_13_355_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_355_1' id='label_13_355_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_353\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_353'>What benefit(s) does this child receive? (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_353' id='input_13_353' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Personal Independence Payment - daily living and mobility' >Personal Independence Payment &#8211; daily living and mobility<\/option><option value='Personal Independence Payment - daily living only' >Personal Independence Payment &#8211; daily living only<\/option><option value='Personal Independence Payment \u2013 mobility only' >Personal Independence Payment \u2013 mobility only<\/option><option value='Disability Living Allowance - care and mobility components' >Disability Living Allowance &#8211; care and mobility components<\/option><option value='Disability Living Allowance - care component only' >Disability Living Allowance &#8211; care component only<\/option><option value='Disability Living Allowance - mobility component only' >Disability Living Allowance &#8211; mobility component only<\/option><\/select><\/div><\/div><div id=\"field_13_350\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_350'>What is their National Insurance number? (6)<\/label><div class='ginput_container ginput_container_text'><input name='input_350' id='input_13_350' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_548\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner pay any childminding costs for this child to a registered childminder, a nursery or an after-school club? (6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_548'>If \u2018Yes\u2019 we may need additional evidence about this depending on your other circumstances<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_548'>\n\t\t\t<div class='gchoice gchoice_13_548_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_548' type='radio' value='Yes'  id='choice_13_548_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_548\"   \/>\n\t\t\t\t\t<label for='choice_13_548_0' id='label_13_548_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_548_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_548' type='radio' value='No'  id='choice_13_548_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_548_1' id='label_13_548_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_282\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another child who lives with you? 6<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_282'>\n\t\t\t<div class='gchoice gchoice_13_282_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_282' type='radio' value='Yes'  id='choice_13_282_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_282_0' id='label_13_282_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_282_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_282' type='radio' value='No'  id='choice_13_282_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_282_1' id='label_13_282_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_377\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About any other children<\/h3><div class='gsection_description' id='gfield_description_13_377'>Please provide the following information for any other children who live with you:\n<p><\/p>\n<p><\/p>\n<ul style=\"list-style-type:disc\">\n <li>Full name<\/li>\n <li>Date of birth<\/li>\n<li>Gender<\/li>\n<li>Do you or your partner receive Child Benefit for this child?  If Yes, how much?<\/li>\n<li>Is this child registered blind?<\/li>\n<li>Has this child been formally placed with you for fostering?<\/li>\n<li>Does this child receive any benefits for disability such as Personal Independence Payment or Disability Living Allowance? If Yes, what benefits and what is their National Insurance number?<\/li>\n<\/ul>\n\n<\/div><\/div><div id=\"field_13_378\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_378'>Please  tell us about any other children<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_378' id='input_13_378' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_278' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_278' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_8' class='gform_page' data-js='page-field-id-278' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_8' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_231\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the other people who live with you<\/h3><div class='gsection_description' id='gfield_description_13_231'>Please tell us about any other people who live with you. This includes other family and friends, boarders, subtenants and lodgers. \n<p><\/p>\n<p><\/p>\nInclude any children they have who live in your household.\n<ul style=\"list-style-type:disc\">\n  <li>Tell us about people who are away studying but return for the holidays and after their course.<\/li>\n  <li>Tell us about people who are in the armed forces on operations.<\/li>\n  <li>Don&#8217;t tell us about people who just share a hall, bathroom and\/or toilet<\/li>\n<\/ul><\/div><\/div><div id=\"field_13_299\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the first other person<\/h3><\/div><div id=\"field_13_290\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_290'>Title (for example Mr, Mrs, Ms, Miss) (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_290' id='input_13_290' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_291\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_291'>First name (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_291' id='input_13_291' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_292\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_292'>Last name (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_292' id='input_13_292' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_296\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_296' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_296_2_container'><label for='input_13_296_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_296[]' id='input_13_296_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_296_1_container'><label for='input_13_296_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_296[]' id='input_13_296_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_296_3_container'><label for='input_13_296_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_296[]' id='input_13_296_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_295\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_295'>National Insurance number (1)<\/label><div class='ginput_container ginput_container_text'><input name='input_295' id='input_13_295' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_300\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a joint owner\/tenant? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_300'>\n\t\t\t<div class='gchoice gchoice_13_300_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_300' type='radio' value='Yes'  id='choice_13_300_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_300_0' id='label_13_300_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_300_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_300' type='radio' value='No'  id='choice_13_300_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_300_1' id='label_13_300_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_301\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_301'>What proportion of the rent\/council do they pay? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_13_301'>For example, 25%, half, etc<\/div><div class='ginput_container ginput_container_text'><input name='input_301' id='input_13_301' type='text' value='' class='large'  aria-describedby=\"gfield_description_13_301\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_302\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they pay rent or money for board and lodgings to you or your partner? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_302'>\n\t\t\t<div class='gchoice gchoice_13_302_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_302' type='radio' value='Yes'  id='choice_13_302_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_302_0' id='label_13_302_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_302_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_302' type='radio' value='No'  id='choice_13_302_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_302_1' id='label_13_302_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_303\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they receive any of the following? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_303'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_303'><div class='gchoice gchoice_13_303_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.1' type='checkbox'  value='Attendance Allowance'  id='choice_13_303_1'   aria-describedby=\"gfield_description_13_303\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_303_1' id='label_13_303_1' class='gform-field-label gform-field-label--type-inline'>Attendance Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_303_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.2' type='checkbox'  value='Disability Living Allowance - care component'  id='choice_13_303_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_303_2' id='label_13_303_2' class='gform-field-label gform-field-label--type-inline'>Disability Living Allowance &#8211; care component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_303_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.3' type='checkbox'  value='Personal Independence Payment - daily living component'  id='choice_13_303_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_303_3' id='label_13_303_3' class='gform-field-label gform-field-label--type-inline'>Personal Independence Payment &#8211; daily living component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_303_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.4' type='checkbox'  value='Armed Forces Independence Payment'  id='choice_13_303_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_303_4' id='label_13_303_4' class='gform-field-label gform-field-label--type-inline'>Armed Forces Independence Payment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_303_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.5' type='checkbox'  value='Income Support'  id='choice_13_303_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_303_5' id='label_13_303_5' class='gform-field-label gform-field-label--type-inline'>Income Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_303_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.6' type='checkbox'  value='Jobseekers Allowance (income based)'  id='choice_13_303_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_303_6' id='label_13_303_6' class='gform-field-label gform-field-label--type-inline'>Jobseekers Allowance (income based)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_303_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.7' type='checkbox'  value='Employment and Support Allowance (income related)'  id='choice_13_303_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_303_7' id='label_13_303_7' class='gform-field-label gform-field-label--type-inline'>Employment and Support Allowance (income related)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_303_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.8' type='checkbox'  value='Pension Credit (Guarantee Credit)'  id='choice_13_303_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_303_8' id='label_13_303_8' class='gform-field-label gform-field-label--type-inline'>Pension Credit (Guarantee Credit)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_303_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.9' type='checkbox'  value='Universal Credit calculated without any earned income'  id='choice_13_303_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_303_9' id='label_13_303_9' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated without any earned income<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_303_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.11' type='checkbox'  value='Universal Credit calculated with earnings'  id='choice_13_303_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_303_11' id='label_13_303_11' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated with earnings<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_303_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_303.12' type='checkbox'  value='None of the above'  id='choice_13_303_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_303_12' id='label_13_303_12' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_304\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they work? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_304'>\n\t\t\t<div class='gchoice gchoice_13_304_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_304' type='radio' value='Yes'  id='choice_13_304_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_304_0' id='label_13_304_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_304_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_304' type='radio' value='No'  id='choice_13_304_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_304_1' id='label_13_304_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_305\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_305'>How many hours per week do they normally work? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_305' id='input_13_305' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_429\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_429'>What is their usual gross weekly earnings? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_429' id='input_13_429' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_430\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they receive any other incomes not previously mentioned in addition to their earnings? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_430'>\n\t\t\t<div class='gchoice gchoice_13_430_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_430' type='radio' value='Yes'  id='choice_13_430_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_430_0' id='label_13_430_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_430_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_430' type='radio' value='No'  id='choice_13_430_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_430_1' id='label_13_430_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_431\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_431'>Please list the other incomes they receive along with the amount normally received each week (person 1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_431' id='input_13_431' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_13_306\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they fall into any of the following categories? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_306'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_306'><div class='gchoice gchoice_13_306_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.1' type='checkbox'  value='Care worker'  id='choice_13_306_1'   aria-describedby=\"gfield_description_13_306\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_306_1' id='label_13_306_1' class='gform-field-label gform-field-label--type-inline'>Care worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_306_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.2' type='checkbox'  value='Apprentice'  id='choice_13_306_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_306_2' id='label_13_306_2' class='gform-field-label gform-field-label--type-inline'>Apprentice<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_306_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.3' type='checkbox'  value='Youth trainee'  id='choice_13_306_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_306_3' id='label_13_306_3' class='gform-field-label gform-field-label--type-inline'>Youth trainee<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_306_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.4' type='checkbox'  value='Severely mentally impaired'  id='choice_13_306_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_306_4' id='label_13_306_4' class='gform-field-label gform-field-label--type-inline'>Severely mentally impaired<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_306_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.5' type='checkbox'  value='In legal custody'  id='choice_13_306_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_306_5' id='label_13_306_5' class='gform-field-label gform-field-label--type-inline'>In legal custody<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_306_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.6' type='checkbox'  value='In hospital'  id='choice_13_306_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_306_6' id='label_13_306_6' class='gform-field-label gform-field-label--type-inline'>In hospital<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_306_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_306.7' type='checkbox'  value='None of the above'  id='choice_13_306_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_306_7' id='label_13_306_7' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_454\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a full time student? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_454'>\n\t\t\t<div class='gchoice gchoice_13_454_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_454' type='radio' value='Yes'  id='choice_13_454_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_454_0' id='label_13_454_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_454_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_454' type='radio' value='No'  id='choice_13_454_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_454_1' id='label_13_454_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_455\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you already provided a copy of their student certificate?  (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_455'>\n\t\t\t<div class='gchoice gchoice_13_455_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_455' type='radio' value='Yes'  id='choice_13_455_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_455_0' id='label_13_455_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_455_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_455' type='radio' value='No'  id='choice_13_455_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_455_1' id='label_13_455_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_462\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_13_462'>Upload a copy of their current student certificate  (1)<\/label><div class='gfield_description' id='gfield_description_13_462'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_13_462' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_13_462&quot;,&quot;container&quot;:&quot;gform_multifile_upload_13_462&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_13_462&quot;,&quot;filelist&quot;:&quot;gform_preview_13_462&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;txt,pdf,doc,docx,rtf,jpg,jpeg,tif,tiff,bmp,png,xls,xlsx&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:13,&quot;field_id&quot;:462,&quot;_gform_file_upload_nonce_13_462&quot;:&quot;40b1580400&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_13_462&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_13_462' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_13_462' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_13_462 gfield_description_13_462\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_13_462'>Accepted file types: txt, pdf, doc, docx, rtf, jpg, jpeg, tif, tiff, bmp, png, xls, xlsx, Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_13_462'><\/ul> <div id='gform_preview_13_462' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_13_307\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another person who lives with you? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_307'>\n\t\t\t<div class='gchoice gchoice_13_307_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_307' type='radio' value='Yes'  id='choice_13_307_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_307_0' id='label_13_307_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_307_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_307' type='radio' value='No'  id='choice_13_307_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_307_1' id='label_13_307_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_288\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the second person<\/h3><div class='gsection_description' id='gfield_description_13_288'>\n<\/div><\/div><div id=\"field_13_406\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_406'>Title (for example Mr, Mrs, Ms, Miss) (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_406' id='input_13_406' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_407\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_407'>First name (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_407' id='input_13_407' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_408\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_408'>Last name (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_408' id='input_13_408' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_395\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_395' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_395_2_container'><label for='input_13_395_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_395[]' id='input_13_395_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_395_1_container'><label for='input_13_395_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_395[]' id='input_13_395_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_395_3_container'><label for='input_13_395_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_395[]' id='input_13_395_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_401\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_401'>National Insurance number (2)<\/label><div class='ginput_container ginput_container_text'><input name='input_401' id='input_13_401' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_391\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a joint owner\/tenant? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_391'>\n\t\t\t<div class='gchoice gchoice_13_391_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_391' type='radio' value='Yes'  id='choice_13_391_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_391_0' id='label_13_391_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_391_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_391' type='radio' value='No'  id='choice_13_391_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_391_1' id='label_13_391_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_389\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_389'>What proportion of the rent\/council do they pay? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_13_389'>For example, 25%, half, etc<\/div><div class='ginput_container ginput_container_text'><input name='input_389' id='input_13_389' type='text' value='' class='large'  aria-describedby=\"gfield_description_13_389\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_387\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they pay rent or money for board and lodgings to you or your partner? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_387'>\n\t\t\t<div class='gchoice gchoice_13_387_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_387' type='radio' value='Yes'  id='choice_13_387_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_387_0' id='label_13_387_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_387_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_387' type='radio' value='No'  id='choice_13_387_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_387_1' id='label_13_387_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_385\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they receive any of the following? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_385'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_385'><div class='gchoice gchoice_13_385_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.1' type='checkbox'  value='Attendance Allowance'  id='choice_13_385_1'   aria-describedby=\"gfield_description_13_385\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_385_1' id='label_13_385_1' class='gform-field-label gform-field-label--type-inline'>Attendance Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_385_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.2' type='checkbox'  value='Disability Living Allowance - care component'  id='choice_13_385_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_385_2' id='label_13_385_2' class='gform-field-label gform-field-label--type-inline'>Disability Living Allowance &#8211; care component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_385_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.3' type='checkbox'  value='Personal Independence Payment - daily living component'  id='choice_13_385_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_385_3' id='label_13_385_3' class='gform-field-label gform-field-label--type-inline'>Personal Independence Payment &#8211; daily living component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_385_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.4' type='checkbox'  value='Armed Forces Independence Payment'  id='choice_13_385_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_385_4' id='label_13_385_4' class='gform-field-label gform-field-label--type-inline'>Armed Forces Independence Payment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_385_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.5' type='checkbox'  value='Income Support'  id='choice_13_385_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_385_5' id='label_13_385_5' class='gform-field-label gform-field-label--type-inline'>Income Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_385_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.6' type='checkbox'  value='Jobseekers Allowance (income based)'  id='choice_13_385_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_385_6' id='label_13_385_6' class='gform-field-label gform-field-label--type-inline'>Jobseekers Allowance (income based)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_385_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.7' type='checkbox'  value='Employment and Support Allowance (income related)'  id='choice_13_385_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_385_7' id='label_13_385_7' class='gform-field-label gform-field-label--type-inline'>Employment and Support Allowance (income related)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_385_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.8' type='checkbox'  value='Pension Credit (Guarantee Credit)'  id='choice_13_385_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_385_8' id='label_13_385_8' class='gform-field-label gform-field-label--type-inline'>Pension Credit (Guarantee Credit)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_385_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.9' type='checkbox'  value='Universal Credit calculated without any earned income'  id='choice_13_385_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_385_9' id='label_13_385_9' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated without any earned income<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_385_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.11' type='checkbox'  value='Universal Credit calculated with earnings'  id='choice_13_385_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_385_11' id='label_13_385_11' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated with earnings<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_385_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_385.12' type='checkbox'  value='None of the above'  id='choice_13_385_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_385_12' id='label_13_385_12' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_383\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they work? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_383'>\n\t\t\t<div class='gchoice gchoice_13_383_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_383' type='radio' value='Yes'  id='choice_13_383_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_383_0' id='label_13_383_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_383_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_383' type='radio' value='No'  id='choice_13_383_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_383_1' id='label_13_383_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_381\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_381'>How many hours per week do they normally work? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_381' id='input_13_381' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_432\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_432'>What is their usual gross weekly earnings? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_432' id='input_13_432' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_433\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they receive any other incomes not previously mentioned in addition to their earnings? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_433'>\n\t\t\t<div class='gchoice gchoice_13_433_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_433' type='radio' value='Yes'  id='choice_13_433_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_433_0' id='label_13_433_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_433_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_433' type='radio' value='No'  id='choice_13_433_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_433_1' id='label_13_433_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_434\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_434'>Please list the other incomes they receive along with the amount normally received each week (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_434' id='input_13_434' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_13_379\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they fall into any of the following categories? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_379'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_379'><div class='gchoice gchoice_13_379_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.1' type='checkbox'  value='Care worker'  id='choice_13_379_1'   aria-describedby=\"gfield_description_13_379\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_379_1' id='label_13_379_1' class='gform-field-label gform-field-label--type-inline'>Care worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_379_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.2' type='checkbox'  value='Apprentice'  id='choice_13_379_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_379_2' id='label_13_379_2' class='gform-field-label gform-field-label--type-inline'>Apprentice<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_379_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.3' type='checkbox'  value='Youth trainee'  id='choice_13_379_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_379_3' id='label_13_379_3' class='gform-field-label gform-field-label--type-inline'>Youth trainee<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_379_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.4' type='checkbox'  value='Severely mentally impaired'  id='choice_13_379_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_379_4' id='label_13_379_4' class='gform-field-label gform-field-label--type-inline'>Severely mentally impaired<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_379_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.5' type='checkbox'  value='In legal custody'  id='choice_13_379_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_379_5' id='label_13_379_5' class='gform-field-label gform-field-label--type-inline'>In legal custody<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_379_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.6' type='checkbox'  value='In hospital'  id='choice_13_379_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_379_6' id='label_13_379_6' class='gform-field-label gform-field-label--type-inline'>In hospital<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_379_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_379.7' type='checkbox'  value='None of the above'  id='choice_13_379_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_379_7' id='label_13_379_7' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_456\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a full time student? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_456'>\n\t\t\t<div class='gchoice gchoice_13_456_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_456' type='radio' value='Yes'  id='choice_13_456_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_456_0' id='label_13_456_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_456_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_456' type='radio' value='No'  id='choice_13_456_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_456_1' id='label_13_456_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_459\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you already provided a copy of their student certificate? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_459'>\n\t\t\t<div class='gchoice gchoice_13_459_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_459' type='radio' value='Yes'  id='choice_13_459_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_459_0' id='label_13_459_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_459_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_459' type='radio' value='No'  id='choice_13_459_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_459_1' id='label_13_459_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_464\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_13_464'>Upload a copy of their current student certificate (2)<\/label><div class='gfield_description' id='gfield_description_13_464'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_13_464' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_13_464&quot;,&quot;container&quot;:&quot;gform_multifile_upload_13_464&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_13_464&quot;,&quot;filelist&quot;:&quot;gform_preview_13_464&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;txt,pdf,doc,docx,rtf,jpg,jpeg,tif,tiff,bmp,png,xls,xlsx&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:13,&quot;field_id&quot;:464,&quot;_gform_file_upload_nonce_13_464&quot;:&quot;358a533283&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_13_464&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_13_464' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_13_464' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_13_464 gfield_description_13_464\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_13_464'>Accepted file types: txt, pdf, doc, docx, rtf, jpg, jpeg, tif, tiff, bmp, png, xls, xlsx, Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_13_464'><\/ul> <div id='gform_preview_13_464' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_13_308\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another person who lives with you? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_308'>\n\t\t\t<div class='gchoice gchoice_13_308_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_308' type='radio' value='Yes'  id='choice_13_308_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_308_0' id='label_13_308_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_308_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_308' type='radio' value='No'  id='choice_13_308_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_308_1' id='label_13_308_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_287\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the third person<\/h3><\/div><div id=\"field_13_409\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_409'>Title (for example Mr, Mrs, Ms, Miss) (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_409' id='input_13_409' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_411\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_411'>First name (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_411' id='input_13_411' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_410\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_410'>Last name (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_410' id='input_13_410' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_398\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_398' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_398_2_container'><label for='input_13_398_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_398[]' id='input_13_398_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_398_1_container'><label for='input_13_398_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_398[]' id='input_13_398_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_398_3_container'><label for='input_13_398_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_398[]' id='input_13_398_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_399\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_399'>National Insurance number (3)<\/label><div class='ginput_container ginput_container_text'><input name='input_399' id='input_13_399' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_392\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a joint owner\/tenant? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_392'>\n\t\t\t<div class='gchoice gchoice_13_392_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_392' type='radio' value='Yes'  id='choice_13_392_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_392_0' id='label_13_392_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_392_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_392' type='radio' value='No'  id='choice_13_392_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_392_1' id='label_13_392_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_390\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_390'>What proportion of the rent\/council do they pay? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_13_390'>For example, 25%, half, etc<\/div><div class='ginput_container ginput_container_text'><input name='input_390' id='input_13_390' type='text' value='' class='large'  aria-describedby=\"gfield_description_13_390\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_388\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they pay rent or money for board and lodgings to you or your partner? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_388'>\n\t\t\t<div class='gchoice gchoice_13_388_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_388' type='radio' value='Yes'  id='choice_13_388_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_388_0' id='label_13_388_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_388_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_388' type='radio' value='No'  id='choice_13_388_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_388_1' id='label_13_388_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_386\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they receive any of the following? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_386'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_386'><div class='gchoice gchoice_13_386_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.1' type='checkbox'  value='Attendance Allowance'  id='choice_13_386_1'   aria-describedby=\"gfield_description_13_386\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_386_1' id='label_13_386_1' class='gform-field-label gform-field-label--type-inline'>Attendance Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_386_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.2' type='checkbox'  value='Disability Living Allowance - care component'  id='choice_13_386_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_386_2' id='label_13_386_2' class='gform-field-label gform-field-label--type-inline'>Disability Living Allowance &#8211; care component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_386_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.3' type='checkbox'  value='Personal Independence Payment - daily living component'  id='choice_13_386_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_386_3' id='label_13_386_3' class='gform-field-label gform-field-label--type-inline'>Personal Independence Payment &#8211; daily living component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_386_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.4' type='checkbox'  value='Armed Forces Independence Payment'  id='choice_13_386_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_386_4' id='label_13_386_4' class='gform-field-label gform-field-label--type-inline'>Armed Forces Independence Payment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_386_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.5' type='checkbox'  value='Income Support'  id='choice_13_386_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_386_5' id='label_13_386_5' class='gform-field-label gform-field-label--type-inline'>Income Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_386_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.6' type='checkbox'  value='Jobseekers Allowance (income based)'  id='choice_13_386_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_386_6' id='label_13_386_6' class='gform-field-label gform-field-label--type-inline'>Jobseekers Allowance (income based)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_386_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.7' type='checkbox'  value='Employment and Support Allowance (income related)'  id='choice_13_386_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_386_7' id='label_13_386_7' class='gform-field-label gform-field-label--type-inline'>Employment and Support Allowance (income related)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_386_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.8' type='checkbox'  value='Pension Credit (Guarantee Credit)'  id='choice_13_386_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_386_8' id='label_13_386_8' class='gform-field-label gform-field-label--type-inline'>Pension Credit (Guarantee Credit)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_386_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.9' type='checkbox'  value='Universal Credit calculated without any earned income'  id='choice_13_386_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_386_9' id='label_13_386_9' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated without any earned income<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_386_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.11' type='checkbox'  value='Universal Credit calculated with earnings'  id='choice_13_386_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_386_11' id='label_13_386_11' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated with earnings<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_386_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_386.12' type='checkbox'  value='None of the above'  id='choice_13_386_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_386_12' id='label_13_386_12' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_384\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they work? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_384'>\n\t\t\t<div class='gchoice gchoice_13_384_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_384' type='radio' value='Yes'  id='choice_13_384_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_384_0' id='label_13_384_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_384_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_384' type='radio' value='No'  id='choice_13_384_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_384_1' id='label_13_384_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_382\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_382'>How many hours per week do they normally work? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_382' id='input_13_382' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_435\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_435'>What is their usual gross weekly earnings? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_435' id='input_13_435' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_436\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they receive any other incomes not previously mentioned in addition to their earnings? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_436'>\n\t\t\t<div class='gchoice gchoice_13_436_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_436' type='radio' value='Yes'  id='choice_13_436_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_436_0' id='label_13_436_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_436_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_436' type='radio' value='No'  id='choice_13_436_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_436_1' id='label_13_436_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_437\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_437'>Please list the other incomes they receive along with the amount normally received each week (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_437' id='input_13_437' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_13_380\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they fall into any of the following categories? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_380'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_380'><div class='gchoice gchoice_13_380_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.1' type='checkbox'  value='Care worker'  id='choice_13_380_1'   aria-describedby=\"gfield_description_13_380\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_380_1' id='label_13_380_1' class='gform-field-label gform-field-label--type-inline'>Care worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_380_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.2' type='checkbox'  value='Apprentice'  id='choice_13_380_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_380_2' id='label_13_380_2' class='gform-field-label gform-field-label--type-inline'>Apprentice<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_380_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.3' type='checkbox'  value='Youth trainee'  id='choice_13_380_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_380_3' id='label_13_380_3' class='gform-field-label gform-field-label--type-inline'>Youth trainee<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_380_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.4' type='checkbox'  value='Severely mentally impaired'  id='choice_13_380_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_380_4' id='label_13_380_4' class='gform-field-label gform-field-label--type-inline'>Severely mentally impaired<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_380_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.5' type='checkbox'  value='In legal custody'  id='choice_13_380_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_380_5' id='label_13_380_5' class='gform-field-label gform-field-label--type-inline'>In legal custody<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_380_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.6' type='checkbox'  value='In hospital'  id='choice_13_380_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_380_6' id='label_13_380_6' class='gform-field-label gform-field-label--type-inline'>In hospital<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_380_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_380.7' type='checkbox'  value='None of the above'  id='choice_13_380_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_380_7' id='label_13_380_7' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_457\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a full time student? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_457'>\n\t\t\t<div class='gchoice gchoice_13_457_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_457' type='radio' value='Yes'  id='choice_13_457_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_457_0' id='label_13_457_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_457_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_457' type='radio' value='No'  id='choice_13_457_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_457_1' id='label_13_457_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_460\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you already provided a copy of their student certificate?  (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_460'>\n\t\t\t<div class='gchoice gchoice_13_460_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_460' type='radio' value='Yes'  id='choice_13_460_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_460_0' id='label_13_460_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_460_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_460' type='radio' value='No'  id='choice_13_460_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_460_1' id='label_13_460_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_463\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_13_463'>Upload a copy of their current student certificate (3)<\/label><div class='gfield_description' id='gfield_description_13_463'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_13_463' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_13_463&quot;,&quot;container&quot;:&quot;gform_multifile_upload_13_463&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_13_463&quot;,&quot;filelist&quot;:&quot;gform_preview_13_463&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;txt,pdf,doc,docx,rtf,jpg,jpeg,tif,tiff,bmp,png,xls,xlsx&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:13,&quot;field_id&quot;:463,&quot;_gform_file_upload_nonce_13_463&quot;:&quot;95e44c0e7a&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_13_463&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_13_463' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_13_463' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_13_463 gfield_description_13_463\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_13_463'>Accepted file types: txt, pdf, doc, docx, rtf, jpg, jpeg, tif, tiff, bmp, png, xls, xlsx, Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_13_463'><\/ul> <div id='gform_preview_13_463' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_13_309\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another person who lives with you? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_309'>\n\t\t\t<div class='gchoice gchoice_13_309_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_309' type='radio' value='Yes'  id='choice_13_309_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_309_0' id='label_13_309_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_309_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_309' type='radio' value='No'  id='choice_13_309_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_309_1' id='label_13_309_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_415\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the fourth person<\/h3><\/div><div id=\"field_13_427\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_427'>Title (for example Mr, Mrs, Ms, Miss) (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_427' id='input_13_427' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_426\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_426'>First name (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_426' id='input_13_426' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_428\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_428'>Last name (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_428' id='input_13_428' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_425\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of birth (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_425' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_425_2_container'><label for='input_13_425_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_425[]' id='input_13_425_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_425_1_container'><label for='input_13_425_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_425[]' id='input_13_425_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_425_3_container'><label for='input_13_425_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_425[]' id='input_13_425_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_424\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_424'>National Insurance number (4)<\/label><div class='ginput_container ginput_container_text'><input name='input_424' id='input_13_424' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_423\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a joint owner\/tenant? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_423'>\n\t\t\t<div class='gchoice gchoice_13_423_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_423' type='radio' value='Yes'  id='choice_13_423_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_423_0' id='label_13_423_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_423_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_423' type='radio' value='No'  id='choice_13_423_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_423_1' id='label_13_423_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_422\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_422'>What proportion of the rent\/council do they pay? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_13_422'>For example, 25%, half, etc<\/div><div class='ginput_container ginput_container_text'><input name='input_422' id='input_13_422' type='text' value='' class='large'  aria-describedby=\"gfield_description_13_422\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_421\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they pay rent or money for board and lodgings to you or your partner? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_421'>\n\t\t\t<div class='gchoice gchoice_13_421_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_421' type='radio' value='Yes'  id='choice_13_421_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_421_0' id='label_13_421_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_421_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_421' type='radio' value='No'  id='choice_13_421_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_421_1' id='label_13_421_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_420\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they receive any of the following? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_420'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_420'><div class='gchoice gchoice_13_420_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.1' type='checkbox'  value='Attendance Allowance'  id='choice_13_420_1'   aria-describedby=\"gfield_description_13_420\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_420_1' id='label_13_420_1' class='gform-field-label gform-field-label--type-inline'>Attendance Allowance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_420_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.2' type='checkbox'  value='Disability Living Allowance - care component'  id='choice_13_420_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_420_2' id='label_13_420_2' class='gform-field-label gform-field-label--type-inline'>Disability Living Allowance &#8211; care component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_420_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.3' type='checkbox'  value='Personal Independence Payment - daily living component'  id='choice_13_420_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_420_3' id='label_13_420_3' class='gform-field-label gform-field-label--type-inline'>Personal Independence Payment &#8211; daily living component<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_420_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.4' type='checkbox'  value='Armed Forces Independence Payment'  id='choice_13_420_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_420_4' id='label_13_420_4' class='gform-field-label gform-field-label--type-inline'>Armed Forces Independence Payment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_420_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.5' type='checkbox'  value='Income Support'  id='choice_13_420_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_420_5' id='label_13_420_5' class='gform-field-label gform-field-label--type-inline'>Income Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_420_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.6' type='checkbox'  value='Jobseekers Allowance (income based)'  id='choice_13_420_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_420_6' id='label_13_420_6' class='gform-field-label gform-field-label--type-inline'>Jobseekers Allowance (income based)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_420_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.7' type='checkbox'  value='Employment and Support Allowance (income related)'  id='choice_13_420_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_420_7' id='label_13_420_7' class='gform-field-label gform-field-label--type-inline'>Employment and Support Allowance (income related)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_420_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.8' type='checkbox'  value='Pension Credit (Guarantee Credit)'  id='choice_13_420_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_420_8' id='label_13_420_8' class='gform-field-label gform-field-label--type-inline'>Pension Credit (Guarantee Credit)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_420_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.9' type='checkbox'  value='Universal Credit calculated without any earned income'  id='choice_13_420_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_420_9' id='label_13_420_9' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated without any earned income<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_420_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.11' type='checkbox'  value='Universal Credit calculated with earnings'  id='choice_13_420_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_420_11' id='label_13_420_11' class='gform-field-label gform-field-label--type-inline'>Universal Credit calculated with earnings<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_420_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_420.12' type='checkbox'  value='None of the above'  id='choice_13_420_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_420_12' id='label_13_420_12' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_419\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they work? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_419'>\n\t\t\t<div class='gchoice gchoice_13_419_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_419' type='radio' value='Yes'  id='choice_13_419_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_419_0' id='label_13_419_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_419_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_419' type='radio' value='No'  id='choice_13_419_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_419_1' id='label_13_419_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_418\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_418'>How many hours per week do they normally work? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_418' id='input_13_418' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_438\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_438'>What is their usual gross weekly earnings? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_438' id='input_13_438' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_439\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do they receive any other incomes not previously mentioned in addition to their earnings? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_439'>\n\t\t\t<div class='gchoice gchoice_13_439_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_439' type='radio' value='Yes'  id='choice_13_439_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_439_0' id='label_13_439_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_439_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_439' type='radio' value='No'  id='choice_13_439_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_439_1' id='label_13_439_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_440\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_440'>Please list the other incomes they receive along with the amount normally received each week (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_440' id='input_13_440' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_13_417\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do they fall into any of the following categories? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_417'>Please select all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_417'><div class='gchoice gchoice_13_417_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.1' type='checkbox'  value='Care worker'  id='choice_13_417_1'   aria-describedby=\"gfield_description_13_417\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_417_1' id='label_13_417_1' class='gform-field-label gform-field-label--type-inline'>Care worker<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_417_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.2' type='checkbox'  value='Apprentice'  id='choice_13_417_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_417_2' id='label_13_417_2' class='gform-field-label gform-field-label--type-inline'>Apprentice<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_417_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.3' type='checkbox'  value='Youth trainee'  id='choice_13_417_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_417_3' id='label_13_417_3' class='gform-field-label gform-field-label--type-inline'>Youth trainee<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_417_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.4' type='checkbox'  value='Severely mentally impaired'  id='choice_13_417_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_417_4' id='label_13_417_4' class='gform-field-label gform-field-label--type-inline'>Severely mentally impaired<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_417_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.5' type='checkbox'  value='In legal custody'  id='choice_13_417_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_417_5' id='label_13_417_5' class='gform-field-label gform-field-label--type-inline'>In legal custody<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_417_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.6' type='checkbox'  value='In hospital'  id='choice_13_417_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_417_6' id='label_13_417_6' class='gform-field-label gform-field-label--type-inline'>In hospital<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_417_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_417.7' type='checkbox'  value='None of the above'  id='choice_13_417_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_417_7' id='label_13_417_7' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_458\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are they a full time student? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_458'>\n\t\t\t<div class='gchoice gchoice_13_458_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_458' type='radio' value='Yes'  id='choice_13_458_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_458_0' id='label_13_458_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_458_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_458' type='radio' value='No'  id='choice_13_458_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_458_1' id='label_13_458_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_461\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you already provided a copy of their student certificate?  (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_461'>\n\t\t\t<div class='gchoice gchoice_13_461_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_461' type='radio' value='Yes'  id='choice_13_461_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_461_0' id='label_13_461_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_461_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_461' type='radio' value='No'  id='choice_13_461_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_461_1' id='label_13_461_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_465\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_13_465'>Upload a copy of their current student certificate (4)<\/label><div class='gfield_description' id='gfield_description_13_465'>If you do not have it available at the moment you can provide it later. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_13_465' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_13_465&quot;,&quot;container&quot;:&quot;gform_multifile_upload_13_465&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_13_465&quot;,&quot;filelist&quot;:&quot;gform_preview_13_465&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/?gf_page=da30025ee0527cd&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/partnershipone.com\\\/TDC\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;txt,pdf,doc,docx,rtf,jpg,jpeg,tif,tiff,bmp,png,xls,xlsx&quot;}],&quot;max_file_size&quot;:&quot;3072000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:13,&quot;field_id&quot;:465,&quot;_gform_file_upload_nonce_13_465&quot;:&quot;bb4d818f16&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_13_465&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_13_465' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_13_465' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_13_465 gfield_description_13_465\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_13_465'>Accepted file types: txt, pdf, doc, docx, rtf, jpg, jpeg, tif, tiff, bmp, png, xls, xlsx, Max. file size: 3 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_13_465'><\/ul> <div id='gform_preview_13_465' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_13_416\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there another person who lives with you? (4)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_416'>\n\t\t\t<div class='gchoice gchoice_13_416_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_416' type='radio' value='Yes'  id='choice_13_416_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_416_0' id='label_13_416_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_416_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_416' type='radio' value='No'  id='choice_13_416_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_416_1' id='label_13_416_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_412\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About any other people who live with you<\/h3><div class='gsection_description' id='gfield_description_13_412'>Please provide the following information for any other people who live with you:\n<p><\/p>\n<p><\/p>\n<ul style=\"list-style-type:disc\">\n <li>Full name<\/li>\n  <li>Date of birth<\/li>\n<li>National Insurance number<\/li>\n<li>Are they a joint owner\/tenant? if Yes what proportion of the rent\/council do they pay?<\/li>\n<li>Do they pay rent or money for board and lodgings to you or your partner?<\/li>\n<li>Do they receive any Allowance or  Independence payments?<\/li>\n<li>Do they work?  If Yes, how many hours?<\/li>\n<li>Are they a: Full time student, care worker, apprentice, youth trainee severely mentally impaired, in legal custody or in hospital?<\/li>\n<\/ul><\/div><\/div><div id=\"field_13_413\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_413'>Please  tell us about any other people<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_413' id='input_13_413' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_13_516\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About any other people who live with you (continued)<\/h3><\/div><fieldset id=\"field_13_517\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do any of the other people listed live together as a couple?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_517'>\n\t\t\t<div class='gchoice gchoice_13_517_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_517' type='radio' value='Yes'  id='choice_13_517_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_517_0' id='label_13_517_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_517_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_517' type='radio' value='No'  id='choice_13_517_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_517_1' id='label_13_517_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_518\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please tell us the full names of the couples<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_518'>Please list all the full names of the couples. Enter the full name and then click on the + sign to add another row for each couple.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Full name &#8211; is the partner of<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Full name<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_518_cell1 gform-grid-col' data-label='Full name - is the partner of'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_518\" aria-label='Full name - is the partner of, Row 1' data-aria-label-template='Full name - is the partner of, Row {0}' type='text' name='input_518[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_518_cell2 gform-grid-col' data-label='Full name'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_518\" aria-label='Full name, Row 1' data-aria-label-template='Full name, Row {0}' type='text' name='input_518[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_155' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_155' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_9' class='gform_page' data-js='page-field-id-155' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_9' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_317\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About any other benefits or household income you (or your partner if you have one) receive<\/h3><\/div><fieldset id=\"field_13_469\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Do you (or your partner if you have one) receive any of the following?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_469'><div class='gchoice gchoice_13_469_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_469.1' type='checkbox'  value='Income Support'  id='choice_13_469_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_469_1' id='label_13_469_1' class='gform-field-label gform-field-label--type-inline'>Income Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_469_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_469.2' type='checkbox'  value='Jobseekers Allowance (income based)'  id='choice_13_469_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_469_2' id='label_13_469_2' class='gform-field-label gform-field-label--type-inline'>Jobseekers Allowance (income based)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_469_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_469.3' type='checkbox'  value='Employment and Support Allowance (income related)'  id='choice_13_469_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_469_3' id='label_13_469_3' class='gform-field-label gform-field-label--type-inline'>Employment and Support Allowance (income related)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_469_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_469.4' type='checkbox'  value='Pension Credit (Guarantee Credit)'  id='choice_13_469_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_469_4' id='label_13_469_4' class='gform-field-label gform-field-label--type-inline'>Pension Credit (Guarantee Credit)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_469_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_469.5' type='checkbox'  value='Pension Credit (Savings Credit only)'  id='choice_13_469_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_469_5' id='label_13_469_5' class='gform-field-label gform-field-label--type-inline'>Pension Credit (Savings Credit only)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_469_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_469.6' type='checkbox'  value='Universal Credit'  id='choice_13_469_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_469_6' id='label_13_469_6' class='gform-field-label gform-field-label--type-inline'>Universal Credit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_469_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_469.7' type='checkbox'  value='None of the above'  id='choice_13_469_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_469_7' id='label_13_469_7' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_319\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is your capital currently below \u00a316,000?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_319'>\n\t\t\t<div class='gchoice gchoice_13_319_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_319' type='radio' value='Yes'  id='choice_13_319_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_319_0' id='label_13_319_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_319_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_319' type='radio' value='No'  id='choice_13_319_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_319_1' id='label_13_319_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_470\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Earnings\/self employment<\/h3><\/div><fieldset id=\"field_13_471\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you or your partner self-employed?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_471'>Select &#8216;No&#8217; if you are a company director<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_471'>\n\t\t\t<div class='gchoice gchoice_13_471_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_471' type='radio' value='Yes'  id='choice_13_471_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_471\"   \/>\n\t\t\t\t\t<label for='choice_13_471_0' id='label_13_471_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_471_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_471' type='radio' value='No'  id='choice_13_471_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_471_1' id='label_13_471_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_472\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >As you or your partner is self-employed you will need to provide additional information, please also complete a <a href=\"https:\/\/forms.thanet.gov.uk\/self-employed-income\" target=\"_blank\">Housing benefit and council tax support self-employed income form<\/a>.  The form link will also be provided at the end of this form.\n<p><p\/><\/div><fieldset id=\"field_13_473\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner do any work for an employer?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_473'>\n\t\t\t<div class='gchoice gchoice_13_473_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_473' type='radio' value='Yes'  id='choice_13_473_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_473_0' id='label_13_473_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_473_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_473' type='radio' value='No'  id='choice_13_473_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_473_1' id='label_13_473_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_474\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the first job<\/h3><div class='gsection_description' id='gfield_description_13_474'>Please answer the following questions about the first job<\/div><\/div><fieldset id=\"field_13_475\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Who is employed in this job? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_475'>\n\t\t\t<div class='gchoice gchoice_13_475_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_475' type='radio' value='I am employed in this job'  id='choice_13_475_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_475_0' id='label_13_475_0' class='gform-field-label gform-field-label--type-inline'>I am employed in this job<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_475_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_475' type='radio' value='My partner is employed in this job'  id='choice_13_475_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_475_1' id='label_13_475_1' class='gform-field-label gform-field-label--type-inline'>My partner is employed in this job<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_476\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_476'>Name of the employer (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_476' id='input_13_476' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_477\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_477'>Address of the employer (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_477' id='input_13_477' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_478\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_478'>Payroll, employee or staff number  (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_478' id='input_13_478' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_479\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date you or your partner started this job (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_479' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_479_2_container'><label for='input_13_479_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_479[]' id='input_13_479_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_479_1_container'><label for='input_13_479_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_479[]' id='input_13_479_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_479_3_container'><label for='input_13_479_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_479[]' id='input_13_479_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><fieldset id=\"field_13_480\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >If this job is due to end soon please tell us the date  (1)<\/legend><div id='input_13_480' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_480_2_container'><label for='input_13_480_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_480[]' id='input_13_480_2'   aria-required='false'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_480_1_container'><label for='input_13_480_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_480[]' id='input_13_480_1'   aria-required='false'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_480_3_container'><label for='input_13_480_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_480[]' id='input_13_480_3'   aria-required='false'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_481\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_481'>How many hours each week do you or your partner usually work? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_481' id='input_13_481' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_487\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_487'>How often are the  wages paid? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_487' id='input_13_487' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Weekly' >Weekly<\/option><option value='Fortnightly' >Fortnightly<\/option><option value='Four weekly' >Four weekly<\/option><option value='Monthly' >Monthly<\/option><\/select><\/div><\/div><fieldset id=\"field_13_483\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >How much are you or your partner normally paid in a typical payslip? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Gross \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Tax deducted \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">National Insurance deducted \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Pension contribution deducted \u00a3<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_483_cell1 gform-grid-col' data-label='Gross \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='Gross \u00a3, Row 1' data-aria-label-template='Gross \u00a3, Row {0}' type='text' name='input_483[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_483_cell2 gform-grid-col' data-label='Tax deducted \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='Tax deducted \u00a3, Row 1' data-aria-label-template='Tax deducted \u00a3, Row {0}' type='text' name='input_483[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_483_cell3 gform-grid-col' data-label='National Insurance deducted \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='National Insurance deducted \u00a3, Row 1' data-aria-label-template='National Insurance deducted \u00a3, Row {0}' type='text' name='input_483[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_483_cell4 gform-grid-col' data-label='Pension contribution deducted \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='Pension contribution deducted \u00a3, Row 1' data-aria-label-template='Pension contribution deducted \u00a3, Row {0}' type='text' name='input_483[]' value=''   \/><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_484\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you or your partner getting Statutory Sick Pay, Maternity Pay, Paternity Pay or Adoption Pay from this employer? (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_484'>\n\t\t\t<div class='gchoice gchoice_13_484_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_484' type='radio' value='Yes'  id='choice_13_484_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_484_0' id='label_13_484_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_484_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_484' type='radio' value='No'  id='choice_13_484_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_484_1' id='label_13_484_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_485\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >When do you expect to return to this job? (1)<\/legend><div id='input_13_485' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_485_2_container'><label for='input_13_485_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_485[]' id='input_13_485_2'   aria-required='false'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_485_1_container'><label for='input_13_485_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_485[]' id='input_13_485_1'   aria-required='false'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_485_3_container'><label for='input_13_485_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_485[]' id='input_13_485_3'   aria-required='false'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><fieldset id=\"field_13_486\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner have any other jobs (1)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_486'>\n\t\t\t<div class='gchoice gchoice_13_486_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_486' type='radio' value='Yes'  id='choice_13_486_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_486_0' id='label_13_486_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_486_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_486' type='radio' value='No'  id='choice_13_486_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_486_1' id='label_13_486_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_488\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the second job<\/h3><div class='gsection_description' id='gfield_description_13_488'>Please answer the following questions about the second job<\/div><\/div><fieldset id=\"field_13_520\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Who is employed in this job? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_520'>\n\t\t\t<div class='gchoice gchoice_13_520_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_520' type='radio' value='I am employed in this job'  id='choice_13_520_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_520_0' id='label_13_520_0' class='gform-field-label gform-field-label--type-inline'>I am employed in this job<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_520_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_520' type='radio' value='My partner is employed in this job'  id='choice_13_520_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_520_1' id='label_13_520_1' class='gform-field-label gform-field-label--type-inline'>My partner is employed in this job<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_521\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_521'>Name of the employer (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_521' id='input_13_521' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_523\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_523'>Address of the employer (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_523' id='input_13_523' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_525\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_525'>Payroll, employee or staff number  (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_525' id='input_13_525' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_527\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date you or your partner started this job (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_527' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_527_2_container'><label for='input_13_527_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_527[]' id='input_13_527_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_527_1_container'><label for='input_13_527_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_527[]' id='input_13_527_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_527_3_container'><label for='input_13_527_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_527[]' id='input_13_527_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><fieldset id=\"field_13_529\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >If this job is due to end soon please tell us the date  (2)<\/legend><div id='input_13_529' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_529_2_container'><label for='input_13_529_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_529[]' id='input_13_529_2'   aria-required='false'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_529_1_container'><label for='input_13_529_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_529[]' id='input_13_529_1'   aria-required='false'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_529_3_container'><label for='input_13_529_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_529[]' id='input_13_529_3'   aria-required='false'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_531\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_531'>How many hours each week do you or your partner usually work? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_531' id='input_13_531' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_533\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_533'>How often are the  wages paid? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_533' id='input_13_533' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Weekly' >Weekly<\/option><option value='Fortnightly' >Fortnightly<\/option><option value='Four weekly' >Four weekly<\/option><option value='Monthly' >Monthly<\/option><\/select><\/div><\/div><fieldset id=\"field_13_535\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >How much are you or your partner normally paid in a typical payslip? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Gross \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Tax deducted \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">National Insurance deducted \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Pension contribution deducted \u00a3<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_535_cell1 gform-grid-col' data-label='Gross \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='Gross \u00a3, Row 1' data-aria-label-template='Gross \u00a3, Row {0}' type='text' name='input_535[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_535_cell2 gform-grid-col' data-label='Tax deducted \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='Tax deducted \u00a3, Row 1' data-aria-label-template='Tax deducted \u00a3, Row {0}' type='text' name='input_535[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_535_cell3 gform-grid-col' data-label='National Insurance deducted \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='National Insurance deducted \u00a3, Row 1' data-aria-label-template='National Insurance deducted \u00a3, Row {0}' type='text' name='input_535[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_535_cell4 gform-grid-col' data-label='Pension contribution deducted \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='Pension contribution deducted \u00a3, Row 1' data-aria-label-template='Pension contribution deducted \u00a3, Row {0}' type='text' name='input_535[]' value=''   \/><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_538\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you or your partner getting Statutory Sick Pay, Maternity Pay, Paternity Pay or Adoption Pay from this employer? (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_538'>\n\t\t\t<div class='gchoice gchoice_13_538_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_538' type='radio' value='Yes'  id='choice_13_538_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_538_0' id='label_13_538_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_538_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_538' type='radio' value='No'  id='choice_13_538_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_538_1' id='label_13_538_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_540\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >When do you expect to return to this job? (2)<\/legend><div id='input_13_540' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_540_2_container'><label for='input_13_540_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_540[]' id='input_13_540_2'   aria-required='false'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_540_1_container'><label for='input_13_540_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_540[]' id='input_13_540_1'   aria-required='false'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_540_3_container'><label for='input_13_540_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_540[]' id='input_13_540_3'   aria-required='false'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><fieldset id=\"field_13_489\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner have any other jobs (2)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_489'>\n\t\t\t<div class='gchoice gchoice_13_489_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_489' type='radio' value='Yes'  id='choice_13_489_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_489_0' id='label_13_489_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_489_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_489' type='radio' value='No'  id='choice_13_489_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_489_1' id='label_13_489_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_490\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the third job<\/h3><div class='gsection_description' id='gfield_description_13_490'>Please answer the following questions about the third job<\/div><\/div><fieldset id=\"field_13_519\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Who is employed in this job? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_519'>\n\t\t\t<div class='gchoice gchoice_13_519_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_519' type='radio' value='I am employed in this job'  id='choice_13_519_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_519_0' id='label_13_519_0' class='gform-field-label gform-field-label--type-inline'>I am employed in this job<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_519_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_519' type='radio' value='My partner is employed in this job'  id='choice_13_519_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_519_1' id='label_13_519_1' class='gform-field-label gform-field-label--type-inline'>My partner is employed in this job<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_522\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_522'>Name of the employer (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_522' id='input_13_522' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_524\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_524'>Address of the employer (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_524' id='input_13_524' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_526\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_526'>Payroll, employee or staff number  (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_526' id='input_13_526' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_528\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date you or your partner started this job (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div id='input_13_528' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_528_2_container'><label for='input_13_528_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_528[]' id='input_13_528_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_528_1_container'><label for='input_13_528_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_528[]' id='input_13_528_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_528_3_container'><label for='input_13_528_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_528[]' id='input_13_528_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><fieldset id=\"field_13_530\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >If this job is due to end soon please tell us the date (3)<\/legend><div id='input_13_530' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_530_2_container'><label for='input_13_530_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_530[]' id='input_13_530_2'   aria-required='false'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_530_1_container'><label for='input_13_530_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_530[]' id='input_13_530_1'   aria-required='false'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_530_3_container'><label for='input_13_530_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_530[]' id='input_13_530_3'   aria-required='false'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_13_532\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_532'>How many hours each week do you or your partner usually work? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_532' id='input_13_532' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_534\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_534'>How often are the  wages paid? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_534' id='input_13_534' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select&#8230;<\/option><option value='Weekly' >Weekly<\/option><option value='Fortnightly' >Fortnightly<\/option><option value='Four weekly' >Four weekly<\/option><option value='Monthly' >Monthly<\/option><\/select><\/div><\/div><fieldset id=\"field_13_537\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >How much are you or your partner normally paid in a typical payslip? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Gross \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Tax deducted \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">National Insurance deducted \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Pension contribution deducted \u00a3<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_537_cell1 gform-grid-col' data-label='Gross \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='Gross \u00a3, Row 1' data-aria-label-template='Gross \u00a3, Row {0}' type='text' name='input_537[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_537_cell2 gform-grid-col' data-label='Tax deducted \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='Tax deducted \u00a3, Row 1' data-aria-label-template='Tax deducted \u00a3, Row {0}' type='text' name='input_537[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_537_cell3 gform-grid-col' data-label='National Insurance deducted \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='National Insurance deducted \u00a3, Row 1' data-aria-label-template='National Insurance deducted \u00a3, Row {0}' type='text' name='input_537[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_537_cell4 gform-grid-col' data-label='Pension contribution deducted \u00a3'><input aria-invalid='false' aria-required=\"true\"  aria-label='Pension contribution deducted \u00a3, Row 1' data-aria-label-template='Pension contribution deducted \u00a3, Row {0}' type='text' name='input_537[]' value=''   \/><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_539\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you or your partner getting Statutory Sick Pay, Maternity Pay, Paternity Pay or Adoption Pay from this employer? (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_539'>\n\t\t\t<div class='gchoice gchoice_13_539_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_539' type='radio' value='Yes'  id='choice_13_539_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_539_0' id='label_13_539_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_539_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_539' type='radio' value='No'  id='choice_13_539_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_539_1' id='label_13_539_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_541\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >When do you expect to return to this job? (3)<\/legend><div id='input_13_541' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_541_2_container'><label for='input_13_541_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_541[]' id='input_13_541_2'   aria-required='false'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_541_1_container'><label for='input_13_541_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_541[]' id='input_13_541_1'   aria-required='false'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_541_3_container'><label for='input_13_541_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_541[]' id='input_13_541_3'   aria-required='false'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><fieldset id=\"field_13_491\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner have any other jobs (3)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_491'>\n\t\t\t<div class='gchoice gchoice_13_491_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_491' type='radio' value='Yes'  id='choice_13_491_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_491_0' id='label_13_491_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_491_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_491' type='radio' value='No'  id='choice_13_491_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_491_1' id='label_13_491_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_492\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About any other jobs<\/h3><div class='gsection_description' id='gfield_description_13_492'>Please provide the following information for any other employment that you or your partner have:\n<p><\/p>\n<p><\/p>\n<ul style=\"list-style-type:disc\">\n <li>Name and address of the employer<\/li>\n <li>Payroll, employee or staff number<\/li>\n<li>Employment start and end date<\/li>\n<li>Hours worked per week<\/li>\n<li>How often wages are paid and the typical amount paid<\/li>\n<li>Details of any statutory, maternity, paternity or adoption pay and expected return date<\/li><\/div><\/div><div id=\"field_13_493\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_493'>Please  tell us about any other employment<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_493' id='input_13_493' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_13_494\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">State Benefits<\/h3><div class='gsection_description' id='gfield_description_13_494'>We need to know about benefits you (or your partner if you have one) receive or have received from the Department for Work and Pensions, The Pension Service, HM Revenue and Customs, Veterans UK or any other government department paying benefits. This includes any State Retirement Pension. <\/div><\/div><fieldset id=\"field_13_495\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner currently receive any state benefits?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_495'>\n\t\t\t<div class='gchoice gchoice_13_495_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_495' type='radio' value='Yes'  id='choice_13_495_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_495_0' id='label_13_495_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_495_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_495' type='radio' value='No'  id='choice_13_495_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_495_1' id='label_13_495_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_496\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Tell us about the benefits received<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_496'>Please list all the benefits received by you and your partner. Enter the information about the benefits and then click on the + sign to add another row for each type you have.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Received by (claimant or partner)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Type of income<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Amount received \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">How often (weekly, fortnightly, four weekly or monthly)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_496_cell1 gform-grid-col' data-label='Received by (claimant or partner)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_496\" aria-label='Received by (claimant or partner), Row 1' data-aria-label-template='Received by (claimant or partner), Row {0}' type='text' name='input_496[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_496_cell2 gform-grid-col' data-label='Type of income'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_496\" aria-label='Type of income, Row 1' data-aria-label-template='Type of income, Row {0}' type='text' name='input_496[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_496_cell3 gform-grid-col' data-label='Amount received \u00a3'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_496\" aria-label='Amount received \u00a3, Row 1' data-aria-label-template='Amount received \u00a3, Row {0}' type='text' name='input_496[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_496_cell4 gform-grid-col' data-label='How often (weekly, fortnightly, four weekly or monthly)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_496\" aria-label='How often (weekly, fortnightly, four weekly or monthly), Row 1' data-aria-label-template='How often (weekly, fortnightly, four weekly or monthly), Row {0}' type='text' name='input_496[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_497\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you or your partner claimed any state benefits?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_497'>\n\t\t\t<div class='gchoice gchoice_13_497_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_497' type='radio' value='Yes'  id='choice_13_497_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_497_0' id='label_13_497_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_497_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_497' type='radio' value='No'  id='choice_13_497_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_497_1' id='label_13_497_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_498\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Tell us about the benefits you have applied for and are awaiting a decision on<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_498'>Please list all the benefits you and your partner have applied for and are awaiting a decision on.  Enter the information about the benefits and then click on the + sign to add another row for each type you have.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Claimed by (claimant or partner)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Benefit claimed<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_498_cell1 gform-grid-col' data-label='Claimed by (claimant or partner)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_498\" aria-label='Claimed by (claimant or partner), Row 1' data-aria-label-template='Claimed by (claimant or partner), Row {0}' type='text' name='input_498[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_498_cell2 gform-grid-col' data-label='Benefit claimed'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_498\" aria-label='Benefit claimed, Row 1' data-aria-label-template='Benefit claimed, Row {0}' type='text' name='input_498[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_13_499\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Other income<\/h3><div class='gsection_description' id='gfield_description_13_499'>We need to know about any other incomes you (or your partner if you have one) receive, for example private pensions and annuities.<\/div><\/div><fieldset id=\"field_13_500\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner receive any other income?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_500'>\n\t\t\t<div class='gchoice gchoice_13_500_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_500' type='radio' value='Yes'  id='choice_13_500_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_500_0' id='label_13_500_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_500_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_500' type='radio' value='No'  id='choice_13_500_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_500_1' id='label_13_500_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_501\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Tell us about any other income received<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_501'>Please list any other income received by you and your partner.  Enter the information about the income then click on the + sign to add another row for each type you have.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Received by (claimant or partner)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Received from<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Type of income<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Amount received \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">How often (weekly, fortnightly, four weekly or monthly)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_501_cell1 gform-grid-col' data-label='Received by (claimant or partner)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_501\" aria-label='Received by (claimant or partner), Row 1' data-aria-label-template='Received by (claimant or partner), Row {0}' type='text' name='input_501[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_501_cell2 gform-grid-col' data-label='Received from'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_501\" aria-label='Received from, Row 1' data-aria-label-template='Received from, Row {0}' type='text' name='input_501[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_501_cell3 gform-grid-col' data-label='Type of income'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_501\" aria-label='Type of income, Row 1' data-aria-label-template='Type of income, Row {0}' type='text' name='input_501[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_501_cell4 gform-grid-col' data-label='Amount received \u00a3'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_501\" aria-label='Amount received \u00a3, Row 1' data-aria-label-template='Amount received \u00a3, Row {0}' type='text' name='input_501[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_501_cell5 gform-grid-col' data-label='How often (weekly, fortnightly, four weekly or monthly)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_501\" aria-label='How often (weekly, fortnightly, four weekly or monthly), Row 1' data-aria-label-template='How often (weekly, fortnightly, four weekly or monthly), Row {0}' type='text' name='input_501[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_503\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >If you (or your partner) are pensioners do you or your partner have any funds in a pension scheme that you do not currently receive any income for?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_503'>\n\t\t\t<div class='gchoice gchoice_13_503_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_503' type='radio' value='Yes'  id='choice_13_503_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_503_0' id='label_13_503_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_503_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_503' type='radio' value='No'  id='choice_13_503_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_503_1' id='label_13_503_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_503_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_503' type='radio' value='Not pension age'  id='choice_13_503_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_503_2' id='label_13_503_2' class='gform-field-label gform-field-label--type-inline'>Not pension age<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_502\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Tell us about any unclaimed pensions<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_502'>If you are pension age we will need evidence showing the amount of income you could currently receive for each if it were converted to a pension or annuity.<p><\/p> \n\nPlease list any unclaimed pensions held by you and your partner.  Enter the information about the pensions and then click on the + sign to add another row for each type you have.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Pension fund for (claimant or partner)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Pension provider<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_502_cell1 gform-grid-col' data-label='Pension fund for (claimant or partner)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_502\" aria-label='Pension fund for (claimant or partner), Row 1' data-aria-label-template='Pension fund for (claimant or partner), Row {0}' type='text' name='input_502[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_502_cell2 gform-grid-col' data-label='Pension provider'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_502\" aria-label='Pension provider, Row 1' data-aria-label-template='Pension provider, Row {0}' type='text' name='input_502[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_505' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_505' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_10' class='gform_page' data-js='page-field-id-505' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_10' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_504\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Captial &#8211; About any bank and building society accounts, savings and investments<\/h3><div class='gsection_description' id='gfield_description_13_504'>Capital includes bank, building society or Post Office accounts, savings or investments (this includes ISAs linked to mortgages), Premium Bonds or stocks and shares, property in the UK or abroad including any money, property or land that is being looked after for you or any money owed to you.\n<p><\/p> \nCapital does not include personal possessions such as cars and jewellery and we do not take into account the value of the property you normally live.\n<p><\/p> \n<strong>Working age<\/strong> &#8211; If your capital is more than \u00a36,000 you will not be entitled Council Tax Support. \n <p><\/p> \n<strong>Pension age<\/strong> &#8211; If your capital is from \u00a310,000 to \u00a315,999, we will take a tariff income from this capital when calculating how much Council Tax Support we can pay. \n<p><\/p> \nIf your capital is above \u00a316,000 you will not be entitled to Council Tax Support.<\/div><\/div><fieldset id=\"field_13_506\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you (or your partner if you have one) own or partly own any land or property registered in your name other than the house you live in here or abroad?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_506'>\n\t\t\t<div class='gchoice gchoice_13_506_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_506' type='radio' value='Yes'  id='choice_13_506_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_506_0' id='label_13_506_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_506_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_506' type='radio' value='No'  id='choice_13_506_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_506_1' id='label_13_506_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_507\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is your total household capital above \u00a35,500?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_507'>\n\t\t\t<div class='gchoice gchoice_13_507_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_507' type='radio' value='Yes'  id='choice_13_507_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_507_0' id='label_13_507_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_507_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_507' type='radio' value='No'  id='choice_13_507_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_507_1' id='label_13_507_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_508\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Tell us about any property or land<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_508'>For each property owned we will need you to complete a <a ref=\"https:\/\/assets.publishing.service.gov.uk\/media\/66019c8cf1d3a0666832acf3\/appendix-a-valuation-of-interest-in-property-or-land-la1.pdf\" target=\"_blank\">LA1 form<\/a> to provide additional information about the property.  \n<p><p\/>\nPlease list the address of any land or property you or your partner own or partly own.  Enter the information and then click on the + sign to add another row for each type you have.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Address of the property or land<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_508_cell1 gform-grid-col' data-label='Address of the property or land'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_508\" aria-label='Address of the property or land, Row 1' data-aria-label-template='Address of the property or land, Row {0}' type='text' name='input_508[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_509\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Tell us about any bank, building society or post office accounts you or your partner have. (If you do not have any write none in the name of bank or building society box)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_509'>Please list all the accounts.  Enter the information and then click on the + sign to add another row for each type you have.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the bank or building society<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Account number (last three numbers)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Amount \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Held by (claimant or partner)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_509_cell1 gform-grid-col' data-label='Name of the bank or building society'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_509\" aria-label='Name of the bank or building society, Row 1' data-aria-label-template='Name of the bank or building society, Row {0}' type='text' name='input_509[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_509_cell2 gform-grid-col' data-label='Account number (last three numbers)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_509\" aria-label='Account number (last three numbers), Row 1' data-aria-label-template='Account number (last three numbers), Row {0}' type='text' name='input_509[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_509_cell3 gform-grid-col' data-label='Amount \u00a3'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_509\" aria-label='Amount \u00a3, Row 1' data-aria-label-template='Amount \u00a3, Row {0}' type='text' name='input_509[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_509_cell4 gform-grid-col' data-label='Held by (claimant or partner)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_509\" aria-label='Held by (claimant or partner), Row 1' data-aria-label-template='Held by (claimant or partner), Row {0}' type='text' name='input_509[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_510\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner have any stocks, shares, bonds or trusts here or abroad?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_510'>\n\t\t\t<div class='gchoice gchoice_13_510_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_510' type='radio' value='Yes'  id='choice_13_510_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_510_0' id='label_13_510_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_510_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_510' type='radio' value='No'  id='choice_13_510_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_510_1' id='label_13_510_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_511\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Tell us about your stocks, shares, bonds or trusts you or your partner have<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_511'>Please list all stocks, shares, bonds or trusts held by you and your partner. Enter the information and then click on the + sign to add another row for each type you have.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of the company<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of shares<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Held by (claimant or partner)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_511_cell1 gform-grid-col' data-label='Name of the company'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_511\" aria-label='Name of the company, Row 1' data-aria-label-template='Name of the company, Row {0}' type='text' name='input_511[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_511_cell2 gform-grid-col' data-label='Number of shares'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_511\" aria-label='Number of shares, Row 1' data-aria-label-template='Number of shares, Row {0}' type='text' name='input_511[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_511_cell3 gform-grid-col' data-label='Held by (claimant or partner)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_511\" aria-label='Held by (claimant or partner), Row 1' data-aria-label-template='Held by (claimant or partner), Row {0}' type='text' name='input_511[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_512\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you or your partner have any National Savings Certificates or Premium Bonds?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_512'>\n\t\t\t<div class='gchoice gchoice_13_512_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_512' type='radio' value='Yes'  id='choice_13_512_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_512_0' id='label_13_512_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_512_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_512' type='radio' value='No'  id='choice_13_512_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_512_1' id='label_13_512_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_513\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Tell us about each National Savings Certificate or Premium Bond you or your partner have<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_513'>Please list all National Savings Certificates and Premium Bonds held by you and your partner. Enter the information and then click on the + sign to add another row for each type you have.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Issue type<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Amount invested \u00a3<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Date of issue<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Held by (claimant or partner)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_513_cell1 gform-grid-col' data-label='Name'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_513\" aria-label='Name, Row 1' data-aria-label-template='Name, Row {0}' type='text' name='input_513[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_513_cell2 gform-grid-col' data-label='Issue type'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_513\" aria-label='Issue type, Row 1' data-aria-label-template='Issue type, Row {0}' type='text' name='input_513[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_513_cell3 gform-grid-col' data-label='Amount invested \u00a3'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_513\" aria-label='Amount invested \u00a3, Row 1' data-aria-label-template='Amount invested \u00a3, Row {0}' type='text' name='input_513[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_513_cell4 gform-grid-col' data-label='Date of issue'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_513\" aria-label='Date of issue, Row 1' data-aria-label-template='Date of issue, Row {0}' type='text' name='input_513[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_513_cell5 gform-grid-col' data-label='Held by (claimant or partner)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_13_513\" aria-label='Held by (claimant or partner), Row 1' data-aria-label-template='Held by (claimant or partner), Row {0}' type='text' name='input_513[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_316' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_316' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_11' class='gform_page' data-js='page-field-id-316' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_11' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_320\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Award start date<\/h3><div class='gsection_description' id='gfield_description_13_320'><p>Your award can be backdated up to 3 months if your circumstances qualify you for Council Tax Support. <\/p>\n\n<p>If you were not entitled to Universal Credit or Pension Credit for this earlier period, we may need to ask for further evidence to allow us to assess any entitlement.<\/p>\n\n<p>Council Tax Support will normally begin from the Monday following the date you want to claim from if it is within the last three months.<\/p>\n\n<p>If you leave this date blank we will either treat your claim as being from the date this form was submitted, or we will consider awarding up to three months backdating if you were entitled to Universal Credit or Pension Credit during that period.  <\/p><\/div><\/div><fieldset id=\"field_13_321\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What date would you like your award to be considered from?<\/legend><div id='input_13_321' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_13_321_2_container'><label for='input_13_321_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_321[]' id='input_13_321_2'   aria-required='false'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_13_321_1_container'><label for='input_13_321_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_321[]' id='input_13_321_1'   aria-required='false'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_13_321_3_container'><label for='input_13_321_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_321[]' id='input_13_321_3'   aria-required='false'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_13_515' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_13_515' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_12' class='gform_page' data-js='page-field-id-515' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_12' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_13_164\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">About the proof you need to provide<\/h3><div class='gsection_description' id='gfield_description_13_164'>Below is a list showing what evidence will be needed to support your claim, this is a general list to provide guidance on what we will need. \n<p><\/p>\nIf you don\u2019t have the evidence don\u2019t worry, just submit the form without it and we will let you know if we need any further evidence in support of your claim. \n<p><\/p>\n<h3>Proof you (and your partner if you have one) need to upload<\/h3>\nAs you or your partner are self-employed, please also complete a <a href=\"https:\/\/forms.thanet.gov.uk\/self-employed-income\" target=\"_blank\">Housing benefit and council tax support self-employed income form<\/a>.\n<p><p\/>\n\n<h4>Proof of identity<\/h4>\n<p>Evidence can include:  birth certificate, marriage certificate, passport, medical card,\ndriving licence, UK residence permit, EU National Identity card, recent gas or electricity bill.\n\n<h4>Proof of National Insurance Number<\/h4>\n<p>Evidence can include: National Insurance card, Department for Work and Pensions (DWP) letter, wage slip, P45\/P60, pension letter, Tax Credit award letter.<\/p>\n<p><\/p>\n<h4>Other income<\/h4>\nIf you receive any other income you will need to provide evidence showing how much is normally received and how often. For pensions or annuities you should normally provide a pension slip showing the payment details including the gross payable and any deductions being made. \n<p><\/p>\n<h4>Capital<\/h4>\n<p>If you receive any other income you will need to provide evidence showing how much is normally received and how often. For pensions or annuities you should normally provide a pension slip showing the payment details including the gross payable and any deductions being made.\n<p><\/p>\n<h4>Income of other adults in your household<\/h4>\nIf you, or your partner, receive Attendance Allowance, Personal Independence Payment Daily Living component or Disability Living Allowance care component we will not need evidence of any non-dependants income as no deduction will be made for them. \n<p><\/p>\n If the other adults in your household normally work for 16 hours or more you will need to provide evidence of their earnings and other income so the correct non-dependant deduction can be taken. For earnings provide their last two monthly, or four weekly pay slips, or last five weekly pay slips. \n\n<\/div><\/div><fieldset id=\"field_13_324\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Will you upload your proof now or within one calendar month?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_324'>\n\t\t\t<div class='gchoice gchoice_13_324_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_324' type='radio' value='I will upload my proof to this form now'  id='choice_13_324_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_324_0' id='label_13_324_0' class='gform-field-label gform-field-label--type-inline'>I will upload my proof to this form now<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_324_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_324' type='radio' value='I can&#039;t upload my proof to this form now, I&#039;ll send it within one calendar month'  id='choice_13_324_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_324_1' id='label_13_324_1' class='gform-field-label gform-field-label--type-inline'>I can&#8217;t upload my proof to this form now, I&#8217;ll send it within one calendar month<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_166\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_13_166'>Please upload proof of any documents we need to see:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_13_166'>If you are uploading photographs of documents, please make sure you take a photo of every relevant page, that they are clear and that any words or figures can be easily read.  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