One-Parent Family Payment Additional Child Application Form (OFP38)

• Published date: 06 July 2021
• Issuer: Department of Social Protection

Page 1

Application form for

Additional Child

One-Parent Family Payment

Data Classification R

Social Welfare Services

OFP 38

• Please use a black ball point pen.

• Please use capital letters and place an X in the relevant boxes.

• Leave boxes blank if they do not apply to you.

• For more information, visit www.gov.ie.

Part 1 Your details

1. PPS Number:

3. Surname:

4. First names:

Mr Mrs Ms Other

2. Title, insert an X or specify:

6. Telephone number:

5. Address:

7. Email address:

8. Are you?

Single

Married

Separated

Divorced

Widowed

Cohabiting

In a Civil Partnership

A surviving Civil Partner

A former Civil Partner

(you were in a Civil Partnership

that has since been dissolved)

9a. Do you own the property you currently live in? Yes No

9b. If yes, do you pay a mortgage on this property? Ye s No

If yes, please state the

mortage you pay: a month

EircodeCounty

10. Do you rent the property you currently live in? Yes No

If yes, please state the rent

you pay: a month

€, .

€, .