Withdrawn

This publication has been withdrawn. It is no longer current.

PRaP 11(MWA) Clerical claim for a start fee

TO ENSURE THE SECURITY OF THE DATA CONTAINED ON THIS FORM, IT MUST NOT BE SENT BY E-MAIL. 

From						To
Provider	
Provider Payment Validation Team
Department for Work and Pensions
Room GW33
Quarry House
Quarry Hill
Leeds
LS2 7UA 	

		

Contract Package Area:

Contract Number:

Name	National Insurance Number	Jobcentreplus Referral Date	MWA Start Date	

I declare that the above information is true & complete and claim a start fee the participant detailed above. 

Signed…………………………………………….. Name ………………………… 

Position ……………………………………………Date ………………………….