1 - ESDS

Q3(B)
Quastxm No
Q3(B) (i)
Q3(C)
Q3(C) (L)
Q3(D)
Codang Sh*at
Rmf erancn
Q3B
Q3Bi amount
Q3C
Q3C1 amount
Q3D
No of
sOxms/
Cbaractmra
2
5
3-E 2-P
2
5
3-E 2=P
2
Codang Instructions/Ramarks
Valuem -3-0~
Pr0s9ntly raca>ving famaly
credit. (Payable to
families with dependent
childrmn ~f hmad/both arc m
full-t- employment. )
NB . on occamion if
unamployad for less than
1 year and entitled
while employed may Wt 111
be receiving
Yes. .......... .......... .01
values -- 1000Q
Only applL08 if
above .
Enter amount.
-s
--
1
coded 1
Prassnt racoiving - NI
rmtzromant penalon or old
ag. pan910n.
rem ............ ...... . ..01
ValUOS -3-1250Q
Only applien If cod-d 1
above .
Entmr amount
Values -3-01
Presently rmc9Lving ancome
support
Yea
NB
. . . . . . . . . . . . . . . 01
This is not paad to
those full-tune Ln
employnmnt.
245