Milk Grant








Details of Head of Household
Identity Card Number:*
Name:*
Surname:*
Date of Birth (DD/MM/YYYY):*
Nationality:*
Mobile:
Telephone:
E-mail:
Contact Details
Address:*
Details of Child for whom this Claim is being made
Name:*
Surname:*
Nationality:*
Date of Birth (DD/MM/YYYY):*
Bank Account Details
Do you have a bank Garnishee Order?:*

If you have a bank garnishee order, provide an official document and payment will be made by cheque. If you do not have a bank garnishee order, fill in the below bank details.
Copy of Garnishee Order if you have blocked Bank Accounts:

Allowance 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:
Necessary Documents
Details of Child (To be filled by Medical Doctor and attach document)
Doctor's Report:*
Declaration
Signed Declaration Form:*
To receive a copy of the application, type your email address below

EmailAddress: