PN1Form Application for student finance

for new students

2021/22 You can also apply online at [Link]/studentfinance

SFE/PN1F/2122/B [Link]/SFEngland [Link]/sf_england

1
You can apply in 5 easy steps
Depending on your circumstances you may not need to complete all of the steps.

1
For all students
• Complete sections 2-6.
• You do not need to complete section 6 if you are only applying for a Tuition Fee Loan.
• If you are applying for a Maintenance Loan, Special Support Loan and/or a Tuition Fee
Loan you need to tell us how much you want by completing the loan request section on
pages 22 and 23.

If you only want to apply for a Tuition Fee Loan and/or a Maintenance Loan that is not based
on household income you can go to Step 5.

2
For students who want student finance based on household income
• Complete sections 7 and 8.
• If you want to apply for a Special Support Loan complete section 9.
• If you’re aged 60 or over on the first day of the first academic year of your course and
are applying for student finance based on your household income, you’ll be assessed
for a Special Support Loan instead of a Maintenance Loan. You do not need to complete
section 9.

3
For students who have dependants
• Complete section 10.
• You should complete this section if you have any children or adult dependants and want
to apply for financial help in relation to them.

If you are a single independent student go directly to Step 5.

4
For students who want student finance based on household income
• Complete section 11.
• Depending on your answers in section 11 you may need to ask your parent(s) or partner
to provide details about their income in section 12 so we can work out what your full
entitlement to student finance will be.

5
For all students
• Make sure that you have signed the terms and conditions on pages 31 and 32.
Your application may be delayed if the terms and conditions are not signed.
• If you asked someone to complete section 12, make sure that they have signed their
declaration(s) on page 41.

Where you see this you should check the notes for specific information to help you complete a
question or section.
Where you see this you need to send us evidence to support your application. Use the notes to
find out exactly what you need to send.

Before completing this form, you should read the Privacy Notice on page 20 of the accompanying notes.
You may be eligible for a bursary or scholarship. In order for a university or college to determine and pay
any bursary or scholarship to which you may be entitled, we will share some of your personal, financial
and course details as well as information about your eligibility for student finance with them. For more
information about this, read our Privacy Notice.
Please contact the university or college if you require further information about their bursaries
and scholarships.

2 SFE/PN1F/2122
 Section 1 Available student finance
If you started your course on or after If you started your course on or after
1 August 2016 you could get: 1 September 2012 and before
• Tuition Fee Loan 1 August 2016 you could get:
• Maintenance Loan • Tuition Fee Loan
• Special Support Loan • Maintenance Loan
• Maintenance Grant
• Special Support Grant

Extra help
You can also apply for additional student finance:
• Childcare Grant • Parents’ Learning Allowance • Bursaries and Scholarships
• Adult Dependants’ Grant • Disabled Students’ Allowance • Travel Grant

Disabled Students’ Allowance (DSA)

If you want to apply for DSA you’ll need to:
• complete and return this form and
• complete a Disabled Students’ Allowance Application Form (DSA slim).
You can download the DSA slim form at: [Link]/studentfinance
Tick the box below if you want us to send you a DSA slim form instead.

Send me a DSA slim form

Go to [Link]/studentfinance to find out more about what student finance is available.

What if I have further questions?

If you have further questions you can:
• visit [Link]/studentfinance
• call us on 0300 100 0607
When do I need to send you my form?
To make sure you receive your first payment at the start of term, you must return this form and all of
the evidence we need by 21 May 2021. We will do our best to process your application as soon as
possible, however if the deadline date has passed, your first payment may not be ready for the start
of term.
If your application form is returned more than 9 months after the start of your academic year it won’t
be processed, and you may lose your full entitlement to student finance for this academic year.
Where do I send my form?
We cannot accept this application form if it is uploaded to your online student finance account.
Return this form to us at: Student Finance England
PO Box 210
Darlington
DL1 9HJ

Please remember to pay the correct postage.

SFE/PN1F/2122 3
 Section 2 Personal details
Personal details

a Title Mr Mrs Miss Ms

Forename(s)

Surname

Any other names you may be known by

Sex Male Female

Date of birth
Please complete the following questions with the
details exactly as stated on your birth certificate or
passport.

Place of birth (the name of the town

or village)

Nationality

National Insurance number

We will share the National Insurance number you provide
with the Department for Work and Pensions to confirm that
it’s valid, and with HM Revenue and Customs to allow us to
collect your repayments.

Identity evidence details

b1 Do you hold a UK passport? Yes No if no go to b3

b2 Provide the following details from your UK passport, which must be currently valid and not
expired (this is the easiest way for you to verify your identity and means you do not need to send
us your passport).
We will share the passport details you provide with HM Passport Office to confirm that they’re valid.
If your passport is not valid or has expired go to b3

Passport number

Forename(s)

Surname

Date of issue

Date of expiry go to c

b3 Send your original non-UK passport or Biometric Residence Permit;

or
Send your original UK birth or adoption certificate.

4 SFE/PN1F/2122
 Section 2 Personal details – continued
Previous loans

c Have you ever had any other loans from

the Student Loans Company Ltd (SLC)? Yes No if no go to d1

If ‘Yes’, are you behind with the

repayments? Yes No

Armed Forces

d1 Are you a member of the Armed Forces

serving outside England? Yes No

d2 Are you a family member of someone

in the Armed Forces serving outside Yes No
England? (For example: spouse or child)

Contact details
e Please give your current home address. If you know it, please also give your term-time
correspondence address.

Home address Term-time address

Postcode Postcode
Home phone number Date on which you will move to this address
/ /

Mobile phone number

Email address
Check you've given us the correct details to make sure we can contact you.

Relationship status
f What is your current relationship status? Single
Living with a partner

Married/civil partnership
Please give the date of marriage/civil partnership
/ /
Separated
Divorced/dissolved civil partnership
Widowed/surviving civil partner

SFE/PN1F/2122 5
 Section 3 Residence

a1 Are you a UK national? No if no go to a2

Yes if yes go to b1

a2 Are you an Irish citizen? No if no go to a3

Yes – have you been resident in the UK and
Islands for the three years prior to the
first day of the first academic year of your
course?

No if no go to a3
Yes if yes go to b2

a3 Are you the family member of a UK

national, and both you and your UK No if no go to a4
national family member were living:
Yes – have both you and your family member
• in the UK on 31 December 2020, been resident in the UK, Gibraltar, EEA
after moving to the UK from the EEA or Switzerland for three years prior to the
or Switzerland on or after 1 January first day of the first academic year of your
2018; or course?
• in the EEA or Switzerland on 31
December 2020? No if no go to a4
Yes if yes go to b2

a4 Have you been granted settled status

or pre-settled status under the EU No if no go to a5
Settlement Scheme? Yes – settled status
Please provide your share code
Please note you don’t need to provide identification
evidence if you provide your share code.

now go to b2

Yes – pre-settled status now go to a5

6 SFE/PN1F/2122
 Section 3 Residence – continued
a5 Are you the child of a Swiss national?
No if no go to a6
Yes – have you been resident in the UK,
Gibraltar, EEA or Switzerland for three
years prior to the first day of the first
academic year of your course?

No if no go to a6
Yes – provide your:
Expiry date of pre-settled status
/ /
Share code
If you are an Irish citizen you do not need to
provide a share code
Please note you don’t need to provide identification
evidence if you provide your share code.

Provide your parent’s or step-parent’s:

Date of birth
/ /
Expiry date of pre-settled status
/ /
Share code

now go to b2

a6 
No if no go to a7
• husband, wife, civil partner; or
• parent(s), step-parent; or Yes – I have been working or looking
• child, step-child for work in the UK.

Yes – my family member has been working or
looking for work in the UK. My family
member is my:

husband/wife/civil partner

parent/step-parent

child/step-child

SFE/PN1F/2122 7
 Section 3 Residence – continued
a6 continued

Have you been resident in the UK,

No if no go to a7
Gibraltar, the EEA and Switzerland for
the three years prior to the first day of
Yes – provide
 details of you/your family
the first academic year of your course?
member’s employment. You should also
provide details of your previous study.

If you/your family member are currently

No if no go to a7
working, will you/your family member
continue to work during your studies?
Yes – provide details:

Provide your:
Expiry date of pre-settled status

/ /
Share code

now go to b2
Provide your family member’s:
Date of birth
/ /
Expiry date of pre-settled status
/ /
Share code
Please note you don’t need to provide identification
evidence if you provide your share code.

now go to b2

8 SFE/PN1F/2122
 Section 3 Residence – continued
a7 Are you the child of a Turkish Worker
who is working in the UK? No if no go to a8
Yes – has your Turkish worker parent/step-
parent been granted extended Leave to
Remain by the Home Office?

No if no go to a8
Yes – were you and your Turkish
worker parent/step-parent
living in the UK by 31
December 2020?

No if no go to a8

Yes now go to b2

a8 Do you have ‘settled status’ in the

UK? No if no go to a9
Yes – provide your:
Home Office reference number

Date latest status granted

/ /
now go to b2

a9 Have you or your:

• husband, wife, civil partner; or No if no go to a10
• parent(s), step-parent
Yes – provide your:
 been granted refugee status by the
Home Office reference number
UK government?

Date latest status granted

/ /
Date this status is due to expire
/ /
Have you lived outside the UK and Islands
since your latest status was granted?

No go to section 4

Yes if yes go to b3

SFE/PN1F/2122 9
 Section 3 Residence – continued
a10 Have you or your:
• husband, wife, civil partner; or
No if no go to a11
• parent(s), step-parent Yes – provide your:
been granted Humanitarian
Home Office reference number
Protection?

Date latest status granted

/ /
Date this status is due to expire
/ /
Have you lived outside the UK and Islands since
your latest status was granted?

No go to section 4
Yes if yes go to b3

a11 Have you or your:

• husband, wife, civil partner; or
No if no go to a12
• parent(s), step-parent Yes – provide your:
been granted ‘Leave to Remain’ as a Home Office reference number
Stateless Person?

Date latest status granted

/ /
Date this status is due to expire
/ /
Have you lived outside the UK and Islands since
your latest status was granted?

No go to section 4
Yes if yes go to b3

10 SFE/PN1F/2122
 Section 3 Residence – continued
a12 Have you been granted ‘Indefinite
Leave to Remain’ in the UK as No if no go to a13
the victim of domestic violence or
Yes – provide your:
abuse?
Home Office reference number

Date latest status granted

/ /

now go to b3

a13 Have you been granted ‘Leave to

Remain’ in the UK under section 67 of No if no go to a14
the Immigration Act 2016, or are you
Yes – provide your:
the dependent child of someone who
Home Office reference number
has?

Date latest status granted

/ /
Date this status is due to expire
/ /
Have you lived outside the UK and Islands since
your latest status was granted?

No go to section 4
Yes if yes go to b3

SFE/PN1F/2122 11
 Section 3 Residence – continued
a14 Have you been granted ‘Calais leave’
in the UK, or are you the dependent No if no go to a15
child of someone who has?
Yes – provide your:
Home Office reference number

Date latest status granted

/ /
Date this status is due to expire
/ /
Have you lived outside the UK and Islands since
your latest status was granted?

No go to section 4
Yes if yes go to b3

a15 Have you been granted ‘Indefinite

Leave to Remain’ as a person who No if no go to a16
has been a bereaved partner?
Yes – provide your:
Home Office reference number

Date latest status granted

/ /

now go to b3

a16 On the first day of the first academic

No if no go to a17
year of your course will you be under
18 and will you have been living in the Yes if yes go to b1
UK and Islands for seven years?

a17 On the first day of the first academic

No if no see below
year of your course will you be over
18 and will you have lived in the UK Yes if yes go to b1
for at least 20 years, or at least half
of your life?

If you’ve answered ‘No’ to all of these questions, you may still be

able to apply for tuition fee only funding. Check the notes for more
information.

12 SFE/PN1F/2122
 Section 3 Residence – continued
b1 In the three years prior to the start of the
first academic year of your course, did No if no go to b4
you live outside the UK and Islands at
any time?
Yes if yes go to b2

b2 Give details of your residence for the Full address

3 years before the start of the first
academic year of your course. There
should be no gaps in the dates you
give us.
From
If you need more space for additional
addresses, give the details above on the To
additional notes at the back of this form.
Why were you there?

Full address

From

To
Why were you there?

Full address

From

To
Why were you there?

Full address

From

To
Why were you there?

now go to b4

SFE/PN1F/2122 13
 Section 3 Residence – continued
b3 Give details of your residency from the Full address
date you received your last status from
the Home Office to the first day of the
first academic year of your course.
If you need more space for additional From
addresses, give the details above on the
additional notes at the back of this form. To
Why were you there?

Full address

From

To
Why were you there?

Full address

From

To
Why were you there?

Full address

From

To
Why were you there?

now go to b4

14 SFE/PN1F/2122
 Section 3 Residence – continued
b4 At any time since 1 September 2018 has:
No go to section 4
• either of your parents, step-parents,
guardians; or Yes if yes give details below
• your husband, wife, civil partner
lived or worked outside the UK and Full address
Islands, or in the case of an EU, EEA
or Swiss national, outside of the UK,
Gibraltar, the EU/EEA or Switzerland?
If you need more space for additional From
addresses, give the details above on the
To
additional notes at the back of this form.
Why were you there?

Full address

From

To
Why were you there?

Full address

From

To
Why were you there?

Full address

From

To
Why were you there?

SFE/PN1F/2122 15
 Section 4 About your course and university or college
In this section, please give details of your first choice university or college and course.
University or college details
a University or college name and address

Postcode

UCAS personal identification number

UCAS university/college code
UCAS campus code (if applicable)

Course details
b1 Course name
If you are following a combined studies or modular
course, please list all subjects being studied

UCAS course code

Qualification you expect to gain
(for example, BSc Physics)

Course start date (month and year)

Course end date (month and year)

Course length (years)

Year of course Foundation year go to b2

First year go to b2
Second year Third year Fourth year
Other (give details)

Is this an accelerated degree course? Yes No

Are you a direct entrant? Yes No

b2 Full tuition fee amount for this academic £

year
If the course is franchised to another
university or college, give the address of
the other university or college

Postcode

16 SFE/PN1F/2122
 Section 4 About your course and university or
college – continued
Course type (tick one box)
c Full-time undergraduate

Full-time Initial Teacher Training (ITT)

courses of up to 2 years in length

Full-time foundation degree

Do you have a disability which prevents you
Full-time distance learning from attending your university or college in
person?
Yes No
Full-time involving a placement
(sandwich course)

Pre-registration postgraduate
healthcare course

Term details
d Where will you be living during term Term 1
time?
Living with parent(s)
We need to know about your living
situation for each term as this can Elsewhere or own home
affect how much student finance Term 2
you can get.
Living with parent(s)
Elsewhere or own home
Term 3
Living with parent(s)
Elsewhere or own home

e Where will you spend the most Term 1

time during the academic year?
University or college
Study abroad
Work placement
Term 2
University or college
Study abroad
Work placement
Term 3
University or college
Study abroad
Work placement

if you have ticked ‘University or college’ for all 3

terms go to section 5

SFE/PN1F/2122 17
 Section 4 About your course and university or
college – continued
f Will you be undertaking a placement
as part of the Erasmus+ exchange
programme or a government-funded
mobility scheme established to if yes or you’ll be studying
replace Erasmus+? Yes No
abroad go to section 5

Placement details
g Where will your placement be? Abroad UK Don’t know
Placement name and address if known

Postcode

Is the placement paid or unpaid? Paid

Unpaid

If ‘unpaid’ please tick which type a hospital, Public Health Service Laboratory or
with a Clinical Commissioning group in the UK;
a Special Health Authority, the National Health
Service Commissioning Board, the National
Institute for Health and Care Excellence, the
Health and Social Care Information Centre,
Local Health Board, Health Board, Special
Health Board or Health and Social Services
Board in the UK;
a Local Authority carrying out its duties
relating to health, welfare or caring for children
and young people, a voluntary organisation
providing facilities or carrying out similar
activities or a Local Authority acting in the
exercise of public health functions in the UK;
the prison or probation sector or after-care
services in the UK;
unpaid research in a UK or overseas institution;
an unpaid placement in the Houses of
Parliament; or
an unpaid placement that is not listed
above.

18 SFE/PN1F/2122
 Section 5 Previous study and other information
Previous study
Courses of higher education are those of Higher National Certificate (HNC) level or above. Where
course details are requested, you should not include A Level/AS Level examinations or equivalent.

a1 Have you started an undergraduate

or postgraduate course of higher
education in any country since leaving
school? Tick ‘Yes’ even if you did not
complete the course. Yes No if no go to b1

a2 Did you achieve a qualification? Yes No if no go to a4

a3 Please tick the relevant box(es) to

show which qualifications you have Degree with Honours e.g. BA (Hons),
achieved. BSc (Hons);

Degree without Honours e.g. BA, BSc

Foundation Degree/Diploma of Higher

Education/Higher National Diploma (HND);

Higher National Certificate (HNC)/Certificate

of Higher Education (CertHE);

Postgraduate Certificate in Education (PGCE);

Graduate Diploma/Certificate;

Master’s Degree;

Postgraduate diploma/certificate;

Other (including all qualifications achieved

abroad)
Give details:

SFE/PN1F/2122 19
 Section 5 Previous study and other information –
continued
a4 Give details of previous courses studied below. Do not mention any course that you studied part-
time where you did not achieve a qualification; or any course that was entirely self-funded at a
private institution where you did not achieve a qualification.

Title of course Full-time, Part- Name of Town and Date Date Did you
and qualification time or Full- university or country of started left achieve a
time distance college university or qualification
learning college
(MM YYYY) (MM YYYY)

Yes No

Yes No

Yes No

Yes No

a5 If you did not achieve a qualification for

any course listed in a4, why was this?

Other information

b1 In this academic year, are you eligible to

apply for a bursary (excluding social work
bursary) from any of the following? Yes No
• National Health Service (NHS)
• Department of Health (DoH) for Northern
Ireland
• Student Awards Agency Scotland (SAAS)

b2 If ‘Yes’, is this bursary or award income

assessed or non-income assessed? Income assessed

Non-income assessed

20 SFE/PN1F/2122
 Section 6 Your UK bank or building society
account details
This account must be in your own name and be able to accept direct credits.
Please note that missing or incorrect bank or building society details will result in your Maintenance Loan,
Special Support Loan, bursary (if applicable) or any grant payments being delayed.
You do not need to provide your bank or building society account details if you are only applying for a
Tuition Fee Loan because this will be paid directly to your university or college and not to you.

- -
Sort code

Account number

Building society roll number (if applicable)

SFE/PN1F/2122 21
 Loan request section
If you are applying for a Maintenance Loan, a Special Support Loan or a Tuition Fee Loan, please
complete this section to tell us how much you want to apply for.

Maintenance Loan
This loan is paid in instalments directly to you and is to help cover your living costs throughout the
academic year.

Amount of Maintenance Loan you would like

to apply for: Maximum available to you Tick
If you wish to apply for less than
the maximum available to you,
£
please state the amount

Special Support Loan

The Special Support Loan is awarded instead of the Maintenance Loan for students who are aged 60 and
over on the first day of the first academic year of their course.

Amount of Special Support Loan you would like

to apply for: Maximum available to you Tick

If you want to apply for less than

the maximum available to you,
please state the amount £

Tuition Fee Loan

Your tuition fee is set by the university or college you go to. Any Tuition Fee Loan you borrow will be
paid directly to your university or college.

I want to apply for a loan to pay the full tuition fee charged by my university
or college. Tick

If you want to apply for less than the maximum available to you, please state
£
the amount

22 SFE/PN1F/2122
 Loan request section – continued

Contact details
We need you to give the name and address of two additional contacts. We’ll only contact them if we
can’t get in touch with you, for example if you move address and forget to tell us.
By entering these details, you’re confirming you’ve told your additional contacts about this and they’re
happy for SLC to contact them if necessary.

Contact 1 Contact 2 (contact 2 must live at a different

address from contact 1)
Forename(s) Forename(s)

Surname Surname

Relationship to you Relationship to you

Address Address

Postcode Postcode
Phone number Phone number

SFE/PN1F/2122 23
 Section 7 Dependent and independent students
This section determines whether you are a dependent or an independent student. This is
important as it establishes whose income we need to take into account from your household
before we calculate your entitlement.

a1 Will you be aged 25 or over on the first

if yes you are an independent
day of the academic year? Yes No
student, go to section 8

a2 Have you been married or in a civil

partnership at any time before the first
if yes you are an independent
day of the academic year? Yes No student, go to section 8

a3 Will you have care of a person under

if yes, you may be
the age of 18 on the first day of the
academic year? Yes No considered an independent
student, go to section 8

b Please tick the relevant box if any of the Your parents cannot be found or it is not
following apply to you reasonably practicable to get in touch with them.

You are irreconcilably estranged (have no

contact with) from your parents and this will not
change.

For any three month period ending after your

16th birthday and before the first day of the first
academic year of your course you have been
in the custody of, in legal care of, or have been
given accommodation by a local authority but
you have not been under the legal care of your
parents.

Both your parents are deceased.

You have applied for student finance before, and

the parent who provided their income details is
deceased.

Your parents are living outside the UK, Gibraltar

or EU and the assessment of their financial
circumstances would place them in jeopardy.

Your parents are living outside the UK, Gibraltar

or EU and it would not be reasonably practicable
or possible for them to send you money.
If you have ticked any of the boxes above,
you will be contacted for evidence and,
subject to this, you may be considered
independent.

if you have ticked any of the

boxes above, go to section 8

24 SFE/PN1F/2122
 Section 7 Dependent and independent students –
continued

c Have you supported yourself financially

for a total of three years or more before
the start of the first academic year of if no you are a dependent
Yes No
your course? student go to section 8

If ‘Yes’, you may be considered an independent student. Please give details below.

Amount of salary
wages or benefit
you have received
Name and address of (state whether it
your employer or your Did you work full or was weekly, monthly
benefit office part-time From To or yearly)

(MM YYYY) (MM YYYY)

SFE/PN1F/2122 25
 Section 8 Student financial questions
The academic year is determined by when you begin your study. Please see page 26 of the guidance
notes for academic year dates.
If you leave any question in this section blank we will not be able to process your application.
If a question does not apply to you, please enter ‘None’ or ‘N/A’ as the answer.

Unearned income
a Taxable unearned income is any income you receive from the following sources:
• Bank or building society gross interest
• Property, lettings or rent
• Dividends or investments
• Trusts or sponsorships
• Any other payment received for attending the course

Estimate the total taxable unearned

income, before deductions, that
you expect to receive in academic
£
year 2021/22.

What is the source of this income?

Payments from an employer

b1 Will your employer be releasing you to
attend your course this academic year? Yes No if no go to c
If ‘Yes’, how much will your employer
pay you for time spent attending your
course during this period? £

b2 During this academic year, will you or

your employer pay any money into a
pension fund on your behalf? Yes No

If ‘Yes’, how much during this period?

£

Dependent children
c Give details of any children who will be wholly or mainly financially dependent on you during this
academic year.
Your child’s income includes their income from all sources after Income Tax and National Insurance
contributions for tax year 2019-20.

Child’s full name Date of birth Relationship Who will they Child’s income
to you live with?
(DD MM YYYY) (£)

26 SFE/PN1F/2122
 Section 9 Special Support
If one of the categories below applies, you may qualify for additional loan for your living costs.
Tick any of the boxes below that are relevant to you. You must send supporting evidence with your
application. Read the notes to find out what evidence to send.
If none of the boxes apply to you, go straight to section 10.

I’m a lone parent or lone foster parent with a child or young person under 20 who is in
full-time education below higher education level or on an approved training course.

I have a partner who is also a student, and one or both of us are responsible for a child,
or young person under 20 who is in full-time education below higher education level or on
an approved training course.

I have a disability and qualify for the Disability Premium or Severe Disability Premium.

I’m deaf and qualify for Disabled Students’ Allowance.

I have been treated as incapable of work for a continuous period of at least 28 weeks.

I have a disability and qualify for income-related Employment and Support Allowance.

I’m waiting to go back to a course having taken agreed time out from that course due to
an illness or caring responsibility that has now ended.

I’m entitled to Personal Independence Payment (PIP).

I’m entitled to Disability Living Allowance (DLA).

I’m entitled to Armed Forces Independence Payment (AFIP).

SFE/PN1F/2122 27
 Section 10 Parents’ Learning Allowance, Childcare
Grant and Adult Dependants’ Grant
Only complete this section if you want to apply for Parents’ Learning Allowance, Childcare Grant or
Adult Dependants’ Grant. You can find out more about these at [Link]/studentfinance
a Are you under 25, living with a partner
and applying for Childcare Grant or
Parents’ Learning Allowance? Yes No if no go to c1

b Give the total estimated income after You Your partner

Income Tax and National Insurance £ £
deductions in this academic year for:
How much of this will be Child Tax Credit You Your partner
or the childcare element of Universal
Credit for this academic year?
£ £

c1 Do you want to apply for Childcare

Grant? Yes No if no go to d1

c2 During the academic year, will you get

one of the following?: Yes No
• the childcare element of Universal If ‘Yes’, you cannot currently apply for Childcare
Credit; or Grant (CCG) as you’re already getting childcare
• The childcare element of Working related funding from another source.
Tax Credit If you choose to stop claiming the other funding,
you could apply for a Childcare Grant.
• Tax Free Childcare from HMRC
• Childcare Allowance from the NHS

c3 Give details of the children you Child 1

need Childcare Grant for during this Forename(s)
academic year

Surname

Date of birth
(DDMMYYYY)
Childcare start
date
(DDMMYYYY)

Child 2
Forename(s)

Surname

Date of birth
(DDMMYYYY)
Childcare start
date
(DDMMYYYY)

If you need more space for additional children, give the details above on the additional
notes at the back of this form.
28 SFE/PN1F/2122
 Section 10 Parents’ Learning Allowance, Childcare Grant
and Adult Dependants’ Grant – continued

d1 Are you applying for Adult

Dependants’ Grant? Yes No if no go to section 11

d2 Who is your adult dependant?

husband,
wife,
civil partner,
or partner
(if you are aged 25 or over) go to section 11

other adult dependant

d3 Will your ‘other adult dependant’s’

income be more than £3,796 in this Yes No
academic year? If ‘Yes’ you won’t be able to receive
Adult Dependants’ Grant.

if yes go to section 11

d4 Give your adult dependant’s income for tax year 2019-20.

Income

All salary, wages and self-employed income

(including income from property)

All pensions (including private, occupational

and state)
If you receive a lump sum pension, only declare the amount
you received that you paid tax on.

All gross taxable income and interest from

savings, investments and dividends

Taxable state benefits

All other taxable income

Deductions

Private pension contributions and

Additional Voluntary Contributions (AVCs)

Allowable expenses on which tax relief

is claimed

SFE/PN1F/2122 29
 Section 11 About your family

If you are a dependent student go to question a.

If you are an independent student with a partner, please read and sign the terms and conditions
on pages 31 and 32 and then pass this form to your partner to complete section 12.

If you are a single independent student, go to the terms and conditions on pages 31 and 32.

a Which parent do you normally live with, or have more contact with?

Mother Father or Both parents N/A

b What is the current relationship status of What you need to do next

this parent? Read and sign the terms and
Single conditions on pages 31 and 32 and
then pass this form to your parent(s).
Living with a partner
Married/civil partnership What your parent(s) need to do next
The parent(s) you normally live with
Separated
should complete section 12.
Divorced/dissolved civil partnership
If the parent indicated in ‘a’ is married,
Widowed/surviving civil partner in a civil partnership or living with a
partner, their partner must also complete
section 12.

30 SFE/PN1F/2122
 Terms and Conditions
These terms and conditions (“terms”) and applicable the terms of any such previous agreement(s).
legislation apply to all of the student finance available If I have reached the age of 18 and refuse to
to students for the academic year 2021/22. “ratify” any previous agreement(s), I understand
I understand that I must read the specific terms about that I will not be eligible to get any further
the student finance products available because they student finance under the regulations.
will affect me if I apply for them at any time in this 8. I agree to give SLC any information they
academic year.
need in support of this application for student
I understand that my application for student finance and to seek repayment.
finance may be delayed unless I sign and date
these terms. 9. I agree to tell SLC immediately if my
circumstances change in any way that might
affect my entitlement to student finance. I
Loan Contract understand that if I do not do this I may not get
1. I confirm I have read and understood these any further payments and I may have to repay
terms and A Guide to Terms and Conditions the student finance I have already received. I
available at [Link]/studentfinance agree that from the date I submit my student
finance application until my loan(s), together
2. I confirm that to the best of my knowledge and with all and any interest, penalties and charges
belief, the information I have provided is true which apply, is fully repaid I must tell SLC
and complete. If it is not, I understand that I about any changes in my personal details
may not receive student finance, any support (including my National Insurance number) and
I have had may be withdrawn and I could be contact details I have provided.
prosecuted. 10. I agree that if I get an overpayment of student
3. I understand that student finance is provided finance, I need to repay this in full and that any
to me by the Secretary of State for Education overpayment may be taken from any future
(the “Lender”) which includes any persons entitlement to student finance.
acting on his/her behalf and any replacement(s) 11. I agree that I will repay the Lender any loan(s),
under section 23(4) of the Teaching and Higher together with all and any interest, penalties
Education Act 1998 as amended or replaced and charges which apply. I understand that
from time to time (the “Act”). this repayment will be due by me to the Lender
4. I understand these terms, the Act and the as a debt. If I breach any of the terms of my
regulations made under section 22 of the Act loan, I agree to pay any charges and penalties
will apply to any student finance provided to which apply under the Act and the regulations.
me by the Lender. I understand that I will repay my loan(s) through
the United Kingdom (“UK”) tax system and/or
5. I understand that “student finance” in these
I may repay SLC directly. If I live abroad, I will
terms means financial support by way of
repay my loan(s) to SLC directly.
grant(s) and/or loan(s) made by the Lender
under the regulations. 12. I agree that any loan(s) made to me in
6. I understand that the Student Loans Company accordance with the regulations once my
application is accepted by the Lender is a/
Limited (“SLC”) carries out certain functions on
are contract(s) between me and the Lender. I
behalf of the Lender.
understand that I am liable for my loan(s) and
My Obligations will be charged interest from the first payment
7. I understand that if I have: of the loan advance by the Lender.
(i) reached the age of 18 years; and 13. I agree to tell SLC if I leave the UK to live
(ii) have entered into agreement(s) for a loan outside the UK or if for any other reason I am
under section 22 of the Act before I reached outside the UK tax system for more than three
the age of 18 years, months.
I am agreeing to “ratify” any and all such
student loans by signing these terms.
This means that I confirm I entered into
agreement(s) with the Lender and agree to

SFE/PN1F/2122 31
 Legal Action and Applicable Law repair costs.
14. In the event of any legal action, I agree that 19. I understand SLC reserves the right to pay
the laws of England and Wales will apply and the suppliers of any approved equipment and
that the courts of that part of the UK will hear support directly. I will be notified if SLC will
any legal action. If my address is outside the make payments directly to suppliers on my
UK the laws of the part of the UK where my behalf.
education provider is situated will apply and Childcare Grant (“CCG”)
the courts of that part of the UK will hear any
legal action. I agree that the Lender has the This section applies if I apply for CCG this
right to take legal action against me in any academic year.
other court with jurisdiction. 20. I understand and agree that in order to
receive any CCG, SLC may share my personal
Sharing Information details and my children’s details with a
15. If I am in breach of these terms and/or the contracted third party who will be handling the
regulations I agree that the Lender may share administration of CCG on behalf of SLC.
information held about me and my account 21. I understand that if I do not take up my
with third parties, including the government or childcare, or if I change to a childcare provider
a government agency of another country, who who is not registered or approved, I will have to
may help to locate me and/or help take action pay back any overpayment.
to recover any payments I owe.
22. I confirm that neither I nor my husband, wife,
16. civil partner or cohabiting partner have chosen
to receive support for childcare from:
(i) the childcare element of Working Tax Credit;
(ii) the childcare element of Universal Credit;
17. I understand that SLC will process my personal
data in line with the Privacy Notice available (iii) Tax-Free Childcare; and/or
at [Link]/privacy-notice (iv) the NHS Bursary Childcare Allowance;
which may be updated from time to time. and I agree to tell SLC immediately if I or my
husband, wife, civil partner or cohabiting
Disabled Students’ Allowance (“DSA”)
partner does receive this support. I understand
This section applies if I apply for DSA this that SLC may share my personal data with
academic year. HMRC to check whether I get childcare
18. support.

Customer Reference Number

Your full name (in BLOCK CAPITALS)

Your signature (in ink)

Today’s date (DDMMYYYY)
X

The relevant person(s) you indicated in section 11 must complete section 12 as well as the declaration(s)
on page 41. Please pass this form to them now.
If you are a single independent student, please turn to page 44.

32 SFE/PN1F/2122
 Section 12 Financial details for tax year 2019-20
for parents and partners
Who needs to complete this section?
Section 11 of this form tells you who needs to complete this section.
What details do I need to provide in this section?
You need to tell us some personal details and what your financial income was for tax year 2019-20. You
must tell us your 2019-20 income details as we cannot accept amounts from any other tax year. We need
your income amounts so we can work out what the student(s) you are supporting is entitled to.

About this section

Section 12 is split into six parts:

Part A - Tell us your name and address and some other personal information.

Part B - Tell us your National Insurance number.

Parts C and D - Answer every question.

Part E - Answer every question and tell us about any income deductions for tax year
2019-20 where appropriate.

Part F - Tell us about any children who are financially dependent on you.

How to complete this section

If you are a single parent of the student
Enter your information as Person 1, leave Person 2 blank.
If there are two parents in the student’s household
Complete this section with information for both Person 1 and Person 2.
If you are an independent student with a partner
Your partner needs to enter their information as Person 1, leave Person 2 blank.
If you’re self assessed – read page 21 of the notes for more information.
If you’re not self assessed – you can use your P60 to complete this section.

What happens if my household income has dropped since tax year 2019-20?
If your household income will be at least 15% less than it was in tax year 2019-20 you can apply for
a Current Year Income (CYI) assessment.
This means we would use your expected income for tax year 2021-22 instead of your actual income
from tax year 2019-20 when calculating the student’s entitlement. However, there must be at least a
15% drop in the overall household income (not just your own income) between these two tax years
for us to do this and we will ask for evidence of your 2021-22 income at the end of that tax year.

Before completing this form, you should read the Privacy Notice on page 26 of the
accompanying notes.
The student may be eligible for a bursary or scholarship. In order for a university or college to
determine and pay any bursary or scholarship to which the student(s) you are supporting may be
entitled, we will share some of your personal and financial details with them. For more information
about this, read our Privacy Notice.

SFE/PN1F/2122 33
 Section 12 Financial details for tax year 2019-20
for parents and partners – continued

Part A – Your personal details

Person 1 Person 2
Your Customer Reference Number Your Customer Reference Number
(if you have one) (if you have one)

Relationship to the student Relationship to the student


Title Title


Forename(s) Forename(s)


Surname Surname

Any other names you may be known by Any other names you may be known by

Date of birth / / Date of birth / /

Place of birth Place of birth
(name of town or village exactly as it appears (name of town or village exactly as it appears
on your birth certificate or passport) on your birth certificate or passport)

Home address Home address

Postcode Postcode

Home telephone number Home telephone number

Email address Email address

You do not have to disclose your financial information to the student.

If you would like to provide your financial information separately, you can download a form at
[Link]/studentfinance or alternatively, you can have the form sent to you by ticking the
box below:

Person 1 Person 2
Send me a separate form Send me a separate form

34 SFE/PN1F/2122
 Section 12 Financial details for tax year 2019-20
for parents and partners – continued

Part B – Data sharing and you

We will share and check the details you give us with HM Revenue & Customs, allowing us
to gain the most accurate information possible. This can only be done if you have a valid
National Insurance (NI) number.

Person 1 Person 2

I have an NI number I have an NI number

Please provide your NI number below: Please provide your NI number below:

- - - -

You are now ready to provide You are now ready to provide
your financial information. your financial information.
go to Part C go to Part C

I do not have an NI number I do not have an NI number

If you do not have an NI number If you do not have an NI number

because you receive non-UK taxable because you receive non-UK taxable
income, please provide the equivalent income, please provide the equivalent
financial information in pounds financial information in pounds
sterling. sterling.

You are now ready to provide You are now ready to provide
your financial information. your financial information.
go to Part C go to Part C

SFE/PN1F/2122 35
 Section 12 Financial details for tax year 2019-20
for parents and partners – continued

Part C - Your financial information for tax year 2019-20

Instructions
• Please give gross financial details for tax year from 6 April 2019 to 5 April 2020.
• Answer ‘Yes’ or ‘No’ to every question. If you answer ‘Yes’ please provide the income amount.
• If any questions are left blank we will not be able to process this application.

You do not need to send us any evidence. However, you should keep all of your
2019-20 financial evidence as we may ask for it at a later date to verify the details you have
provided.

Person 1 Person 2
Q1 Did you receive any income from salary, wages,
taxable state benefits or from occupational or private Yes No Yes No
pensions?
a Total income from salary/wages £ £

b Total income from taxable state benefits £ £

c Total income from occupational pension(s) £ £



d £ £


Person 1 Person 2
Q2 Did you receive any income from a state retirement
pension? Yes No Yes No

a Total lump sum amount received £ £

b Total non-lump sum amount received £ £

36 SFE/PN1F/2122
 Section 12 Financial details for tax year 2019-20
for parents and partners – continued

Person 1 Person 2
Q3 Did you receive any income from savings and
investments? Yes No Yes No

a Total interest from UK banks, building societies and £ £

unit trusts

b Total income from UK life insurance gains, securities

£ £
and partnerships
£ £
c Total income from UK investments and dividends
£ £
d Total income from foreign investment and dividends

Person 1 Person 2
Q4 Did you receive any taxable benefits in kind? Yes No Yes No

Total income received from taxable benefits in kind £ £

Q5 Did you receive any other income during tax year 2019-20 that you haven’t yet told us about?

Person 1 go to Part D Person 2 go to Part D

Yes Yes

No go to Part E No go to Part E

SFE/PN1F/2122 37
 Section 12 Financial details for tax year 2019-20
for parents and partners – continued

Part D - Other income

Instructions
• Complete Part D in the same way you completed Part C giving gross financial details for the tax
year from 6 April 2019 to 5 April 2020.

Person 1 Person 2
Q1 Did you receive any income from self-employment? Yes No Yes No

a Total adjusted profit from businesses

£ £

b Total adjusted profit from partnerships

£ £

Q2 Yes No Yes No

Total taxable income minus expenses that are not £

included on your P60 or P11D
£

Q3 Did you receive any other taxable income or lump

sums? Yes No Yes No

£ £
Total income received

Q4 Did you receive any income from property Yes No Yes No

lettings?
£ £
Total income received

Q5 Did you receive any income from UK trusts? Yes No Yes No

Total income received

£ £

38 SFE/PN1F/2122
 Section 12 Financial details for tax year 2019-20
for parents and partners – continued

Person 1 Person 2

Q6 Did you receive any foreign income? Yes No Yes No

Total income received £ £

Q7 Did you receive any income from an overseas pension? Yes No Yes No

Total income received £ £

Q8 Did you receive any other overseas income

and gains? Yes No Yes No

Total income received £ £

Part E – Income deductions

Instructions
• Complete Part E in the same way you completed Part C giving gross financial details for the tax
year from 6 April 2019 to 5 April 2020.

Person 1 Person 2
Q1 Did you pay any private pension contributions? Yes No Yes No

£ £
Total amount you paid

Person 1 Person 2
Q2 Did you pay any Additional Voluntary
Contributions (AVCs)? Yes No Yes No

Total amount you paid

£ £

Person 1 Person 2
Q3 Did you have any allowable expenses on which
you claimed tax relief? Yes No Yes No

Total amount on which you claimed tax relief

£ £

SFE/PN1F/2122 39
 Section 12 Financial details for tax year 2019-20
for parents and partners – continued
Part F – Your dependants
Identify any children who will be wholly or mainly financially dependent on you.
Q1 Child dependants not in further or higher education in academic year 2021/22
Include unearned income for all dependants. Only include earned income details for persons
aged 16 and over. Do not count casual earnings of persons under 16.

If you require more space please use the additional notes section from page 42.

Full name Full name

Date of birth (DDMMYYYY) Date of birth (DDMMYYYY)

Income for the year Income for the year

Q2 Child dependants in further or higher education in academic year 2021/22

Do not include the applicant when completing this question.

If the student is your partner, please include any children they named in section 8 of this form if
the children have applied for student finance.

If you require more space please use the additional notes section from page 42.

Full name Full name

Date of birth (DDMMYYYY) Date of birth (DDMMYYYY)

School, college or university School, college or university

Course Course

Are they receiving financial support? If so, from Are they receiving financial support? If so, from
which authority or organisation? which authority or organisation?

Do you want to support this student’s Do you want to support this student’s
application for student finance? application for student finance?

Yes No Yes No

40 SFE/PN1F/2122
 Declaration for parents and partners
This application for financial support may be delayed unless you sign and date this declaration.
• I confirm that to the best of my knowledge and belief, the information I have provided is true and
complete. If it is not I understand the student(s) I am supporting may have their support withdrawn and
I could be prosecuted.
• I agree to supply any further information in relation to the applicant’s application for financial support
that SLC may ask for and agree to tell them immediately if my circumstances change in any way that
might affect this application for financial support.

Person 1 Person 2

Your full name (in BLOCK CAPITALS) Your full name (in BLOCK CAPITALS)

Your signature Your signature

X X
Today’s date (DDMMYYYY) Today’s date (DDMMYYYY)

Deadline
To make sure the student receives their first payment at the start of term, this form must be returned with
all of the evidence we need by 21 May 2021.

We will do our best to process the application as soon as possible, however if the deadline date has
passed, the first payment may not be ready for the start of term.

Now pass this form back to the student.

SFE/PN1F/2122 41
 Additional notes
If you are providing extra information please clearly mark what section and question the information is
about.

42 SFE/PN1F/2122
 Additional notes
If you are providing extra information please clearly mark what section and question the information is
about.

SFE/PN1F/2122 43
 Voluntary questions
The following questions are voluntary - you do not have to answer them. Whether or not you answer will
not affect our assessment of your entitlement to financial support. If you answer both questions a and
b, the information will be used to help the Department for Education develop their policies in the future.
Student Finance England will also use your answer to question b to improve their ability to deliver suitable
and accessible educational services that meet the varied needs of their communities in the future.

a Your parents’ education (this includes your natural parents, your adoptive parents, your
step-parents, partners of your parents, and your guardians).

Do any of your parents (as defined

above) have any higher education
qualifications, for example degrees
and diplomas or certificates of higher
education?
Yes No Don’t know

b How would you describe your ethnic

origin?
White
British
Irish
Any other white background

Black or Black British

African
Caribbean
Any other black background

Mixed
White and black Caribbean
White and black African
White and Asian
Any other mixed background

Chinese or other ethnic group

Chinese
Any other

Asian or Asian British

Indian
Pakistani
Bangladeshi
Any other Asian background

44 SFE/PN1F/2122
 Checklist
Before you return this form please make sure that:

You have answered all the questions that apply to you

The terms and conditions are signed and dated

You have included all the evidence we need with this form

If you don’t send all the evidence we need, your application may be delayed and you may
end up getting less student finance than you are entitled to.

Remember, you don’t need to send your UK passport as proof of your identity. You only
need to complete your UK passport details in section 2. If you send your passport it
may take several weeks before we can return it to you.

What happens next

It can take at least 6 weeks to assess your application and all the relevant evidence. We’ll then send you a
letter showing the amount of financial support you’ll receive.

You must return your completed form to the address shown below.

Student Finance England

PO Box 210
Darlington
DL1 9HJ

Deadline
To make sure you receive your first payment at the start of term, you must return this form and all of the
evidence we need by 21 May 2021. We will do our best to process your application as soon as possible,
however if the deadline date has passed, your first payment may not be ready for the start of term.
If your application form is returned more than 9 months from the start of your academic year it won’t be
processed, and you may lose your full entitlement to student finance.

SFE/PN1F/2122 45