Vale of Glamorgan Forms

Vale of Glamorgan Forms

Self-Isolation Support Payment Form

Application Information

If you have been contacted by TTP and have been told to self-isolate, you may be entitled to financial support.

Self-Isolation Support Payment
If you meet ALL of the eligibility criteria, you are entitled to an Isolation Payment of £500

  • You have been told to self-isolate by:
    • NHS Wales, Test, Trace, Protect service (TTP) on or after 23 October 2020
    • Your child has been asked to isolate from their school, childcare setting or further education college on or after 23 October 2020
    • You have received notification from the NHS Covid-19 App because you have been in close contact with a positive case on or after 1 February 2021

    Parents and carers who meet the following criteria:

    • The child attends a school or childcare setting up to and including Year 8 (or up to age 19 if the learner has multiple and complex needs);
    • The child has been asked to self-isolate by TTP or has been asked to self-isolate for 10 days or more by the school or child-care setting as a result of an outbreak in a school, childcare or further education setting;
  • You are employed or self-employed
  • You cannot work from home and will lose income as a result
  • You or your partner are currently receiving at least one of the following benefits: Universal Credit, Working Tax Credit, income-based Employment and Support Allowance, income-based Job Seekers Allowance, Income Support, Housing Benefit and/or Pension Credit

Discretionary Payment
You may be eligible for a £500 Discretionary Payment if you meet all of the other eligibility criteria above, but:

  • You or your partner Do Not currently receive Universal Credit, Working Tax Credit, income-based Employment and Support Allowance, income-based Job Seekers Allowance, Income Support, Housing Benefit and/or Pension Credit
  • You will face financial Hardship as a result of not being able to work while you are self- isolating.
This application is for one person only and any further applications within the same household must be made by each individual

Please ensure that you have the information below available before starting your application

  • National Insurance Number
  • Confirmation of the date given by NHS Wales Test, Trace, Protect service (TTP)
  • Your most recent Bank Statement, wage slip or proof of self-employment


Applicant details


Employment Details


Benefits



Bank Details

Please provide the following details of the bank account you wish the payment to go into.


To Enable your application to be processed quickly, please upload your evidence documents. If you are employed this should also include proof of employment e.g. Wages being paid into your Bank Account, or your most recent Wage Slip or Bank Statement

If your application is because of a Notification via the NHS Covid 19 app, you will need to provide the screenshot of the notification, along with evidence from your employer that you did not work during this period. If you do not provide thisyour application will be refused.

If you are self-employed you must provide a written statement confirming you did not work during this period.

If you are self-employed – please provide evidence of this, such as self-employed accounts which show recent trading or SA302 self-assessment form

If you do not provide evidence which supports your application it will lead to a delay in processing your claim.

In either case please provide your latest bank statements.


Please select all files at once.


Declarations

  • I confirm that the information is true and accurate.
  • I agree to stay at home and self-isolate for the required period, I understand that if I fail to do so, I will be required to pay the funds back and my contact details may be passed on to the police for further action.

If you are unable to confirm to all the statements above, you are not eligible for the fund.

As part of making this application, please note that Welsh Government, or a research company employed by them may invite you to take part in follow up research. This would involve passing your contact details to Welsh Government. Your details will only be used for research purposes and your personal details will be kept completely confidential. If you are re-contacted there will be no obligation to take part.


Equality Data (Optional)

The next set of questions asks about your personal characteristics. This is to help us understand the take up of the scheme among different groups of the population. Where possible, these questions have been aligned with those used by the Office for National Statistics (ONS).

Age

Sex

Ethnicity

What is your ethnic group? Choose one option that best describes your ethnic group or background.

Disability

Your data will be processed under the terms of the Vale of Glamorgan Council Privacy Notice