Form

Support for a child conceived without your consent

Form to claim extra benefit or tax credits for a child conceived without your consent, if they are your third or subsequent child.

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Details

You will not be paid an extra amount of Child Tax Credit, Income Support or Universal Credit for more than 2 children, unless the children were born before 6 April 2017 or exceptions apply.

One of those exceptions applies if:

  • your child was conceived as a result of a non-consensual sexual act (including rape), or
  • you were in a controlling or coercive relationship with the other biological parent of the child at the time of the conception

To apply for an extra amount for that child, fill in this form with the help of a:

  • healthcare professional
  • specialist support worker from an approved organisation listed on this page
  • registered social worker

Use the separate form for Northern Ireland if you live there.

Published 6 April 2017
Last updated 28 June 2017 + show all updates
  1. Added Refuge to the list of approved third party professionals who can complete these forms.
  2. Published updated forms and guidance to clarify that the claimant must not be living with the other biological parent of the child.
  3. Added Welsh versions of the form and guidance.
  4. Removed Dogs Trust Freedom Project form list of third party professionals.
  5. First published.