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In-Work Benefit Test Form

In-Work Benefit

Applicant’s Details - Head of Household

Identity Card Number *

Name *

Surname *

Civil Status * Civil Status

Nationality *

Contact Number *

Email *

Is Head of Household employed? *

Yes

Select the applicable employment of the previous year *

Employed

Self-Occupied

Employment Details (Head of Household)

Enter number of employment periods in previous year (e.g: 2) *

Company Name 1 *

Upload FS3 or Profit & Loss account *

Maximum file size: 4MB

Company Name 2 *

Upload FS3 or Profit & Loss account *

Maximum file size: 4MB

Company Name 3 *

Upload FS3 or Profit & Loss account *

Maximum file size: 4MB

Company Name 4 *

Upload FS3 or Profit & Loss account *

Maximum file size: 4MB

Company Name 5 *

Upload FS3 or Profit & Loss account *

Maximum file size: 4MB

Self-Occupied Details

Copy of receipt/s with the amount paid as social security contributions

Maximum file size: 5MB

If no receipts are uploaded, the amount paid as contributions will not be taken into account when assessing claim.

Did you receive wage supplement from Malta Enterprise *

Yes

Upload document showing wage supplement from Malta Enterprise

Maximum file size: 4MB

Spouse Details

Identity Card Number *

Name *

Surname *

Civil Status * Civil Status

Date of Marriage/Cohabitation (DD/MM/YYYY) *

Nationality *

Contact Number

Is Spouse Employed?

Yes

Select the applicable employment of the previous year *

Employed

Self-Occupied

Employment Details (Spouse)

Enter number of employments (e.g: 2) *

Company Name *

Upload FS3 or Profit & Loss account *

Maximum file size: 4MB

Company Name *

Upload FS3 or Profit & Loss account *

Maximum file size: 4MB

Company Name *

Upload FS3 or Profit & Loss account *

Maximum file size: 4MB

Company Name *

Upload FS3 or Profit & Loss account *

Maximum file size: 4MB

Company Name *

Upload FS3 or Profit & Loss account *

Maximum file size: 4MB

Self-Occupied Details

Copy of receipt/s with the amount paid as social security contributions

Maximum file size: 5MB

If no receipts are uploaded, the amount paid as contributions will not be taken into account when assessing claim.

Did you receive wage supplement from Malta Enterprise *

Yes

Upload document showing wage supplement from Malta Enterprise *

Maximum file size: 4MB

If the spouse / partner works abroad, give details of the person, the foreign address of where he / she resides as well as employment details in that country and FS3 for basic year 2020.

Address

House/Flat Number *

Street *

Locality *

Country *

Post Code *

Do you have children under the age of 23 residing at the same address? *

Yes

If you do not have children under the age of 23, you are not entitled to in-work benefit.

Enter the number of children, under the age of 23, residing in the same address

Details of Children Residing at the Same Address

Name

Surname

Identity Card Number

Date of Birth (DD/MM/YYYY)

Name

Surname

Identity Card Number

Date of Birth (DD/MM/YYYY)

Name

Surname

Identity Card Number

Date of Birth (DD/MM/YYYY)

Name

Surname

Identity Card Number

Date of Birth (DD/MM/YYYY)

Bank Account Details

If you have a garnishee order, please inform your preferred bank about the amendment to Article 318 of the Code of Organisation and Civil Procedure, to have a bank account issued in your name accordingly.

Benefit should be deposited in a Savings or Current Account, but not in a Loan Account. The indicated account has to be in the name of the beneficiary.

Bank *

IBAN *

Enter Mobile Number for an SMS notification regarding payment

A copy of the declaration form must be attached. Download and upload: Click Here -

Upload a scanned copy of the Declaration Form here

Maximum file size: 4MB

Additional Information

Insert email address here to receive a copy of your application.

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