Childcare Funding Re – Declaration Form

To complete this form you will need to be the parent or carer that applied for the funding code with HMRC.

You will also need the following :

Your funding award code / letter from the borough (if Applicable)

Please state the funding period this applies to

Child's name

Has your child's age category changed?

Has your child's eligibility code changed?

What will your age category be?

What is your funding eligibility?

Please provide your new eligibility code

Please provide your national insurance number

Is your child on 3 years plus funding?

What is your funding eligibility?

Please provide your new eligibility code

Please provide your national insurance number

Is your child attending the same days as the last funding period?

Please check all days your child attends/will attend

Please check to confirm that this change of days has been approved by Wise Owls head office

Print full name

Signature

Clear Signature

Date