Download JSON
{
"filename": "CH2_English_online.pdf",
"model": "Anthropic",
"formStructure": [
0,
13,
14,
8,
13,
13,
10,
0,
0
],
"pages": [
{
"id": 1,
"question_text": "Do you have a National Insurance number?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 2,
"question_text": "Your title",
"answer_type": "single_choice",
"options": [
{
"text": "Mr",
"value": "Mr"
},
{
"text": "Mrs",
"value": "Mrs"
},
{
"text": "Ms",
"value": "Ms"
},
{
"text": "M",
"value": "M"
},
{
"text": "W",
"value": "W"
},
{
"text": "Dr",
"value": "Dr"
}
]
},
{
"id": 3,
"question_text": "Your last name or family name",
"answer_type": "name"
},
{
"id": 4,
"question_text": "Your first name and any middle names",
"answer_type": "name"
},
{
"id": 5,
"question_text": "Have you ever been known by any other last names or family names including your maiden name?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 6,
"question_text": "Your date of birth",
"answer_type": "date",
"answer_settings": {
"input_type": "date_of_birth"
}
},
{
"id": 7,
"question_text": "Your address",
"answer_type": "address"
},
{
"id": 8,
"question_text": "Have you lived at this address for more than 12 months?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 9,
"question_text": "Tell us your last address",
"answer_type": "address"
},
{
"id": 10,
"question_text": "Your mobile number or landline if you do not have a mobile",
"answer_type": "phone_number"
},
{
"id": 11,
"question_text": "What is your nationality?",
"hint_text": "This is shown on your passport if you have one, for example, British, Irish, French, Polish.",
"answer_type": "text"
},
{
"id": 12,
"question_text": "Have you claimed Child Benefit for any children before?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 13,
"question_text": "Are you currently entitled to or receiving Child Benefit?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 1,
"question_text": "Have you always lived in the UK?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 2,
"question_text": "Do you usually live in the UK?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 3,
"question_text": "Which country do you usually live in?",
"answer_type": "text"
},
{
"id": 4,
"question_text": "Tell us the date you arrived in the UK",
"answer_type": "date",
"answer_settings": {
"input_type": "other_date"
}
},
{
"id": 5,
"question_text": "Are you subject to immigration control now, or have you been at any time in the last 6 months?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 6,
"question_text": "If you've been subject to immigration control in the last 3 months, tell us the date your immigration status was granted",
"answer_type": "date",
"answer_settings": {
"input_type": "other_date"
}
},
{
"id": 7,
"question_text": "What is your employment status?",
"answer_type": "single_choice",
"options": [
{
"text": "Looking for work in the UK",
"value": "Looking for work in the UK"
},
{
"text": "Employed in the UK",
"value": "Employed in the UK"
},
{
"text": "Self-employed in the UK",
"value": "Self-employed in the UK"
},
{
"text": "None of these - I've enough money to support my family in the UK",
"value": "None of these - I've enough money to support my family in the UK"
}
]
},
{
"id": 8,
"question_text": "Do you work in another country or receive benefits from another country, or have you at any time in the last 3 months?",
"answer_type": "yes_no_question"
},
{
"id": 9,
"question_text": "Are you a member of HM Forces or a civil servant working abroad?",
"answer_type": "yes_no_question"
},
{
"id": 10,
"question_text": "What is your marital or civil partnership status?",
"answer_type": "single_choice",
"options": [
{
"text": "Married or in a civil partnership, go to question 24",
"value": "Married or in a civil partnership, go to question 24"
},
{
"text": "Living with a partner as if you're married or a civil partner since",
"value": "Living with a partner as if you're married or a civil partner since"
},
{
"text": "Widowed, go to question 34",
"value": "Widowed, go to question 34"
},
{
"text": "Separated, go to question 34",
"value": "Separated, go to question 34"
},
{
"text": "Divorced, go to question 34",
"value": "Divorced, go to question 34"
},
{
"text": "Single, go to question 34",
"value": "Single, go to question 34"
}
]
},
{
"id": 11,
"question_text": "Your partner's full name",
"answer_type": "name",
"answer_settings": {
"input_type": "full_name"
}
},
{
"id": 12,
"question_text": "Your partner's date of birth",
"answer_type": "date",
"answer_settings": {
"input_type": "date_of_birth"
}
},
{
"id": 13,
"question_text": "Your partner's National Insurance number",
"answer_type": "national_insurance_number"
},
{
"id": 14,
"question_text": "Your partner's nationality",
"answer_type": "text",
"hint_text": "This is shown on their passport if they have one, for example British, Irish, French, Polish."
},
{
"id": 28,
"question_text": "What is your partner's employment status?",
"answer_type": "single_choice",
"options": [
{
"text": "Looking for work in the UK",
"value": "Looking for work in the UK"
},
{
"text": "Employed in the UK",
"value": "Employed in the UK"
},
{
"text": "Self-employed in the UK",
"value": "Self-employed in the UK"
},
{
"text": "None of these - they have enough money to support their family in the UK",
"value": "None of these - they have enough money to support their family in the UK"
}
]
},
{
"id": 29,
"question_text": "Is your partner a member of HM Forces or a civil servant working abroad?",
"answer_type": "yes_no_question"
},
{
"id": 30,
"question_text": "Does your partner now, or have they at any time in the last 3 months, worked in another country or received benefit from another country?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 31,
"question_text": "Is your partner entitled to Child Benefit now or are they waiting to hear if they can get Child Benefit?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 32,
"question_text": "What is the full name of the eldest child your partner is entitled to Child Benefit for?",
"answer_type": "name"
},
{
"id": 33,
"question_text": "Child's date of birth",
"answer_type": "date",
"answer_settings": {
"input_type": "date_of_birth"
}
},
{
"id": 34,
"question_text": "How many children are you claiming for on this form?",
"answer_type": "number"
},
{
"id": 35,
"question_text": "How many original birth certificates, adoption certificates, passports or travel documents are you sending us? If you do not send original documents a decision on your claim may be delayed.",
"answer_type": "number"
},
{
"id": 36,
"question_text": "Child's full name including last or family name",
"answer_type": "name"
},
{
"id": 37,
"question_text": "Is this child male or female?",
"answer_type": "single_choice",
"options": [
{
"text": "Male",
"value": "Male"
},
{
"text": "Female",
"value": "Female"
}
]
},
{
"id": 38,
"question_text": "Child's date of birth",
"answer_type": "date",
"answer_settings": {
"input_type": "date_of_birth"
}
},
{
"id": 39,
"question_text": "Has this child's birth been registered in England, Wales or Scotland?",
"answer_type": "yes_no_question"
},
{
"id": 40,
"question_text": "Has this child ever been known by any other name?",
"answer_type": "yes_no_question"
},
{
"id": 41,
"question_text": "Has the name been changed by deed poll?",
"answer_type": "yes_no_question"
},
{
"id": 42,
"question_text": "Is this child your:",
"answer_type": "single_choice",
"options": [
{
"text": "Birth child",
"value": "Birth child"
},
{
"text": "Adopted child",
"value": "Adopted child"
},
{
"text": "Stepchild",
"value": "Stepchild"
},
{
"text": "None of these",
"value": "None of these"
}
]
},
{
"id": 43,
"question_text": "Have you or anyone else ever claimed Child Benefit for this child? Read page 4 of the CH2 Notes.",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 44,
"question_text": "What is the name and address of the person who claimed Child Benefit for this child?",
"answer_type": "text"
},
{
"id": 45,
"question_text": "Does this child live with you in the UK?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 46,
"question_text": "Has this child lived with anyone else at a different address to you in the last 12 months?",
"answer_type": "yes_no_question",
"needs_routing": true
},
{
"id": 47,
"question_text": "What date did the child come to live with you?",
"answer_type": "date",
"answer_settings": {
"input_type": "other_date"
}
},
{
"id": 48,
"question_text": "Are you adopting or planning to adopt this child through a local authority?",
"answer_type": "yes_no_question"
},
{
"id": 49,
"question_text": "Child's full name including last or family name As shown on their birth or adoption certificate",
"answer_type": "name",
"hint_text": "Child's last name, Child's first name, Child's middle names"
},
{
"id": 50,
"question_text": "Is this child male or female?",
"answer_type": "single_choice",
"options": [
{
"text": "Male",
"value": "Male"
},
{
"text": "Female",
"value": "Female"
}
]
},
{
"id": 51,
"question_text": "Child's date of birth",
"answer_type": "date",
"answer_settings": {
"input_type": "date_of_birth"
}
},
{
"id": 52,
"question_text": "Has this child's birth been registered in England, Wales or Scotland?",
"answer_type": "yes_no_question",
"hint_text": "No If No, send the documents as shown on page 4 of this form - 'Documents we need', Yes If Yes, tell us the reference numbers from the bottom left hand corner of their birth certificate - read page 4 of the CH2 Notes",
"needs_routing": true
},
{
"id": 53,
"question_text": "Has this child been known by any other names?",
"answer_type": "yes_no_question",
"hint_text": "No Yes If Yes, tell us the other name"
},
{
"id": 54,
"question_text": "Has the name been changed by deed poll?",
"answer_type": "yes_no_question",
"hint_text": "No Yes"
},
{
"id": 55,
"question_text": "Is this child: Read page 4 of the CH2 Notes",
"answer_type": "single_choice",
"options": [
{
"text": "Birth child",
"value": "Birth child"
},
{
"text": "Adopted child",
"value": "Adopted child"
},
{
"text": "Stepchild",
"value": "Stepchild"
},
{
"text": "None of these",
"value": "None of these"
}
]
},
{
"id": 56,
"question_text": "Have you or anyone else ever claimed Child Benefit for this child? Read page 4 of the CH2 Notes.",
"answer_type": "yes_no_question",
"hint_text": "No If No go to question 58, Yes If Yes go to question 57",
"needs_routing": true
},
{
"id": 57,
"question_text": "What is the name and address of the person who claimed Child Benefit for this child?",
"answer_type": "text",
"hint_text": "Name, Address"
},
{
"id": 58,
"question_text": "Does this child live with you in the UK? Read page 4 of the CH2 Notes.",
"answer_type": "yes_no_question",
"hint_text": "No If No, tell us the name and address of the person they live with, Yes If Yes go to question 59",
"needs_routing": true
},
{
"id": 59,
"question_text": "Has this child lived with anyone else at a different address to you in the last 12 months? Read page 4 of the CH2 Notes.",
"answer_type": "yes_no_question",
"hint_text": "No If No go to question 61, Yes If Yes, tell us their name, address and telephone number",
"needs_routing": true
},
{
"id": 60,
"question_text": "What date did the child come to live with you?",
"answer_type": "date"
},
{
"id": 61,
"question_text": "Are you adopting or planning to adopt this child through a local authority?",
"answer_type": "yes_no_question",
"hint_text": "No Yes If you want to claim for any more children, go to page 7 of the CH2 Notes and fill in the 'Additional children' form"
},
{
"id": 1,
"question_text": "Do you want to be paid Child Benefit?",
"answer_type": "yes_no_question",
"hint_text": "Only answer this question if either you or your partner have an individual income of more than £60,000 a year."
},
{
"id": 2,
"question_text": "How you want to be paid",
"answer_type": "single_choice",
"options": [
{
"text": "We normally pay Child Benefit every 4 weeks on a Monday into a bank or building society account.",
"value": "We normally pay Child Benefit every 4 weeks on a Monday into a bank or building society account."
},
{
"text": "If Yes, go to question 65",
"value": "If Yes, go to question 65"
},
{
"text": "If No, go to question 66",
"value": "If No, go to question 66"
}
],
"needs_routing": true
},
{
"id": 3,
"question_text": "To get Child Benefit paid every week tick all boxes which apply to you or your partner",
"answer_type": "multiple_choice",
"options": [
{
"text": "I am a single parent",
"value": "I am a single parent"
},
{
"text": "I or my partner receive one or more of the following: • Income Support • income-based Jobseeker's Allowance • Pension Credit • income-related Employment and Support Allowance • Universal Credit",
"value": "I or my partner receive one or more of the following: • Income Support • income-based Jobseeker's Allowance • Pension Credit • income-related Employment and Support Allowance • Universal Credit"
}
]
},
{
"id": 4,
"question_text": "Do you already get Child Benefit?",
"answer_type": "yes_no_question",
"hint_text": "If Yes, go to question 66",
"needs_routing": true
},
{
"id": 5,
"question_text": "Bank details",
"answer_type": "text",
"hint_text": "Tell us the account details where you want us to pay your Child Benefit into. The account must be in your name, or in the name of your partner if you are part of a couple. We use partner to mean: • a person you are married to or a person you live with as if you are married to them, or • a civil partner or a person you live with as if you are civil partners"
},
{
"id": 6,
"question_text": "Name of the bank or building society",
"answer_type": "text"
},
{
"id": 7,
"question_text": "The branch sort code. Read page 5 of the CH2 Notes.",
"answer_type": "text"
},
{
"id": 8,
"question_text": "The account number. Read page 5 of the CH2 Notes.",
"answer_type": "text"
},
{
"id": 9,
"question_text": "If the account is with a building society, tell us the roll or reference number if you have it. Read page 5 of the CH2 Notes.",
"answer_type": "text"
},
{
"id": 10,
"question_text": "If you do not have an account that we can pay into, put an 'X' in this box",
"answer_type": "single_choice",
"options": [
{
"text": "",
"value": ""
}
]
}
]
}