I, SÉAMAS Ó RIAIN, Minister for Social Welfare, in exercise of the powers conferred on me by the Social Welfare (Children's Allowances) Acts, 1944 to 1952, hereby make the following Regulations:

PART I.PRELIMINARY.

1 Short title.

1. These Regulations may be cited as the Social Welfare (Children's Allowances) (General) Regulations, 1952.

2 Definitions.

2. In these Regulations—

" the Act of 1944 " means the Children's Allowances Act, 1944 (No. 2 of 1944);

" the Regulations of 1946 " means the Children's Allowances (General) Regulations, 1946 (S. R. & O., No. 116 of 1946).

PART II.CLAIMS.

3 Manner of claiming.

3.—(1) A claim for a children's allowance shall—

(a) be made in the Form No. 1 of the Schedule hereto or in such form substantially to the like effect as the Minister may determine,

(b) contain the particulars indicated in the form,

(d) be sent to the Secretary, Department of Social Welfare.

(2) A claim in relation to a qualified child of whom account has not been taken in computing the rate of children's allowance to which the claimant is for the time being entitled, shall—

(a) be made in Form No. 2 of the Schedule hereto or in such form substantially to the like effect as the Minister may determine,

(b) contain the particulars indicated in the form,

(d) be sent to the Secretary, Department of Social Welfare.

4 Incomplete claims.

4. Where a claim for a children's allowance is not duly signed or attested or is in other respects incomplete or is made otherwise than in the appropriate form, the Minister may, if the claim is duly made or completed within two months after the date on which the appropriate form is sent to the claimant for completion, treat the claim as having been duly made under these Regulations.

5 Claims of incorrect form.

5. Where a claim for a children's allowance has been made otherwise than in the appropriate form, the Minister may, if he thinks fit, treat the claim as if it had been made in the appropriate form.

6 Claim by agent.

6. Where a qualified person is, by reason of mental or other incapacity, unable to apply for a children's allowance, or has omitted to do so for reasons which appear to the Minister to justify or excuse the omission, the Minister may, in his discretion and subject to such conditions as he thinks fit—

(i) appoint a person to apply on behalf of that person, or

(ii) receive a claim on behalf of that person from any other person.

7 Commencement of awards.

7. Where a children's allowance is awarded on a claim made in accordance with paragraph (1) of Regulation 3 hereof, the children's allowance shall commence to accrue as follows:

(a) on the 1st day of the month following that in which the claimant became a qualified person, provided that the claim has been made within the three months commencing on that 1st day of the month,

(b) if, in the case of a person having two or more qualified children normally residing with him on the 1st day of July, 1952, the claim is made within the three months commencing on that date—on the 1st day of July, 1952,

(c) in the case of a claim made by a person who becomes a qualified person by and on the death of another person who, at the date of his death, had been entitled to a children's allowance—on the 1st day of the month following that in which the claim is made or, at the discretion of the Minister, on the 1st day of the month following that in which the claimant became a qualified person,

(d) in any other case—on the 1st day of the month following that in which claim is made.

8 Taking effect of revision on account of change of circumstances.

8.—(1) Where, by virtue of a revised award made by a deciding officer in accordance with section 9 of the Act of 1944, on account of a relevant change of circumstances, a children's allowance will be increased, the revised award shall take effect—

(a) as from the 1st day of the month following that in which the additional child becomes normally resident with the claimant, provided that the claim is made within three months commencing on that 1st day of the month,

(b) in any other case—as from the 1st day of the month following that in which the claim is made.

(2) Where, by virtue of a revised award or decision made or given by a deciding officer in accordance with section 9 of the Act of 1944, on account of a relevant change of circumstances, a children's allowance will cease to be payable or be reduced, the revised award or decision shall take effect as follows :

(a) in case there was, in relation to the change of circumstances any statement or representation (whether written or oral), which was to the knowledge of the person making it false or misleading in any material respect or any wilful concealment of a material fact—as from the 1st day of the month following that in which the change of circumstances occurred,

(b) in any other case—as from the date on which notice of the revised award or decision is given to the person concerned.

9 Determination of claim and notice of award.

9.—(1) A deciding officer, in giving his award or decision on any claim in respect of a children's allowance or any question arising thereon or in relation to a children's allowance which has been awarded, may have regard to such evidence or information as appears to him to be sufficient for the purpose.

(2) The Minister shall cause due notice of the award or decision of a deciding officer in respect of a children's allowance to be given in writing to the person concerned.

PART III.PAYMENT OF CHILDREN'S ALLOWANCES.

10 Mode of payment of children's allowances.

10.—(1) Subject to paragraph (6) of this Regulation, children's allowances shall be payable in advance on the first Tuesday in each month by means of orders (in these Regulations referred to as children's allowance orders) payable in each case at such post office as the Minister may from time to time determine or in accordance with paragraph (3) of this Regulation.

(2) The Minister shall cause arrangements to be made whereby, on furnishing such evidence of identity and such other particulars as may be required, a person entitled (whether on his own behalf or on behalf of some other person) to payment of a children's allowance may obtain (either through the postmaster of such post office as the Minister may direct for the purpose, or otherwise) a book of children's allowance orders.

(3) At the request in writing of a person who has been awarded a children's allowance, such children's allowance may be paid either to that person or another person on his behalf by means of children's allowance orders to be accepted by a bank for lodgment to the credit of the payee's account in such bank.

(4) The Minister shall cause arrangements to be made for the issue to every person entitled (whether on his own behalf or on behalf of some other person) to payment of a children's allowance of a fresh book of children's allowance orders on the expiration of the previous book.

(5) A person entitled to a children's allowance shall furnish in writing a statement, in such form as the Minister may require and at such times as the Minister may determine, with respect to his continuing to be entitled to such children's allowance.

(6) The Minister may arrange for the payment of children's allowances otherwise than in accordance with paragraphs (1) and (3) of this Regulation.

11 Nomination of person to receive a children's allowances.

11.—(1) A person who is entitled to a children's allowance may, with the consent of the Minister, nominate any one of the following persons to receive the said children's allowance on his behalf—

(a) the mother of the children in respect of whom the children's allowance is payable,

(b) an immediate female relative of those children over the age of eighteen years,

(i) a female over the age of eighteen years who resides with or has charge of those children, or

(ii) any other responsible person.

(2) Every nomination under paragraph (1) of this Regulation—

(i) shall be in the form set out in paragraph 5 of Form No. 1 of the Schedule hereof, or such form substantially to the like effect as the Minister may determine, and shall be sent to the Secretary, Department of Social Welfare,

(ii) may, by notice in writing given to the Minister, be revoked with effect as from such date as the Minister may, in his discretion, permit.

(3) The Minister may, whenever he thinks fit, withdraw his consent to a nomination under this Regulation, and in such case the person therein nominated shall, on receipt of notice of such withdrawal, send to the Minister the allowance book issued to him.

12 Appointment of agent to receive a children's allowances on behalf of incapacitated person.

12.—(1) Where a person who is entitled (whether on his own behalf or on behalf of some other person) to payment of a children's allowance is, owing to mental or other incapacity, unable to obtain payment thereof, the Minister may, on written application being made to him, appoint a person to receive the said children's allowance on behalf of such incapacitated person subject to such conditions as the Minister thinks fit.

(2) A person to whom a book of children's allowance orders has been issued and who, by reason of illness or for any other sufficient reason, is unable to attend at the post office to obtain payment, may, in a form provided for the purpose, appoint an agent to obtain payment on his behalf, and such appointment may be made for a particular month or for a period not exceeding three months.

PART IV.PROCEDURE ON REFERENCES.

13 Definitions for this Part.

13. In this Part of these Regulations—

" application for a reference " means an application under Regulation 14 hereof

" hearing " means an oral hearing,

" referee " includes two or more referees acting together,

" reference " means the reference of a decision or award of a deciding officer to a referee under subsection (2) of Section 8 of the Act of 1944.

14 Application for reference.

14.—(1) A person who is dissatisfied by the award or decision of a deciding officer may, at any time within one month after the date upon which notification of that award or decision was sent to him or such extended period as the Minister may, in his discretion, allow, apply to the Minister, in accordance with this Regulation, to have the question referred to a referee.

(2) Every application for a reference shall contain a concise statement of the facts and contentions upon which the applicant intends to rely.

(3) The applicant shall send to the Minister the application for a reference, together with such documentary evidence as the applicant desires to adduce in support of his application, and the application shall contain a list of all such documents.

(4) Any person desiring to withdraw an application for a reference may do so by sending to the Minister a notice of withdrawal.

15 Submission of question to referee.

15. Where an application for a reference is duly made to the Minister, the Minister shall, as soon as may be, cause to be supplied to a referee a copy of the application for a reference, together with a statement showing to what extent the facts stated in the application are admitted or disputed and setting out any further facts and the contentions which will be relied upon on behalf of the Minister at the hearing, and shall send to the applicant a copy of that statement.

16 Powers of referee.

16.—(1) Where an application for a reference is referred to a referee, the following provisions shall have effect—

(a) the referee may at any time require the applicant or the Minister to furnish to him, in writing, further particulars with respect to the reference, and may at any stage of the proceedings allow the amendment of any application, statement or particulars and may fix the time for furnishing any statement or particulars upon such terms as he may think just;

(b) if the referee is of opinion that the case is of such a nature that it can properly be determined without a hearing, he may dispense with a hearing and may determine the reference summarily;

(c) if in the opinion of the referee a hearing is required he shall, as soon as may be, fix a date and place for the hearing, and shall send to the Minister not less than twelve days' notice of the date and place fixed for the hearing and the Minister shall thereupon cause to be sent to the applicant not less than seven days' notice of the date and place fixed for the hearing;

(d) the applicant and the Minister shall not, without the leave of the referee, be entitled to rely upon any facts or contentions other than those set out in the application for a reference and in the statement required to be supplied under Regulations 14 and 15 hereof.

(2) A referee may consider and decide any question duly referred to him for consideration and determination, notwithstanding the failure or neglect of any person to comply with any request or requirement of the referee.

17 Procedure on hearing.

17. The following provisions shall apply in relation to the hearing by a referee of a reference—

(a) the applicant may appear in person, or by any member of his family, or, with the consent of the referee, by any other representative;

(b) the Minister may be represented by an officer of his Department;

(d) the referee may, if he thinks fit, admit any duly authenticated written statement or other material as prima facie evidence of any fact or facts in any case in which he thinks it just and proper so to do;

(e) the referee may, if he thinks fit, call for such documents and examine such witnesses as appear to him likely to afford evidence relevant and material to the issue although not tendered on behalf of the applicant or the Minister;

(f) the referee may consider and determine the questions arising at a hearing notwithstanding the absence of any party who has been duly notified of the hearing;

(g) the procedure shall be such as the referee may determine.

18 Decision of referee.

18.—(1) The decision of the referee on a reference shall be in writing signed by him and shall be sent, as soon as may be, to the Minister.

(2) As soon as may be after the receipt by the Minister of the decision of the referee, the Minister shall cause a memorandum of the decision to be prepared and shall send a copy of the memorandum to the applicant.

19 Questions referred to a referee under section 8 (3) of the Act of 1944.

19. Where a deciding officer refers any question arising on a claim for a children's allowance to a referee under subsection (3) of section 8 of the Act of 1944, the following provisions shall have effect—

(a) the deciding officer shall supply to the referee a notice in writing of the question upon which he desires the determination of the referee ;

(b) the provisions of Regulations 16, 17 and 18 hereof shall apply in relation to the determination of the said question with the necessary modifications, including the modification that subparagraph (d) of paragraph (1) of Regulation 16 shall not apply.

PART V.PAYMENTS ON DEATH.

20 Sum payable on death.

20. In this Part " sum payable on death " in relation to a deceased person means—

(i) in case he was entitled to a children's allowance, any sum on account of the children's allowance which became payable within three months before the date of his death but has not been paid;

(ii) in case he applied for a children's allowance for which he was qualified and died before his claim was allowed, any sum which, if his claim had been allowed immediately before his death, would have become payable on account of the children's allowance up to the date of his death.

21 Time-limit for payment of sum payable on death.

21. Notwithstanding anything in section 18 of the Act of 1944 but subject to these Regulations, the Minister may, if a claim to a sum payable on death is made to him within six months of the death of the deceased person or such longer time as the Minister, having regard to the circumstances of the particular case, may determine, pay the sum payable on death.

22 Distribution of sum payable on death.

22.—(1) On the death of the deceased person any sum payable on death may be paid or distributed by the Minister without probate or other proof of the title of his personal representatives but nothing in this Regulation shall authorise the Minister, where he has not already made payment of the sum payable on the death of the deceased person to refuse payment of such sum to any person entitled thereto who produces probate or other proof of title.

(2) Where the sum payable on death is payable to persons appearing to the Minister to be beneficially entitled thereto under any will or other testamentary writing, the sum payable on death may be paid or distributed to or among such of the persons appearing to be beneficially entitled thereto as aforesaid as the Minister thinks proper and that to the exclusion of all others, without prejudice to any remedy which such others may have for recovery of the sum so paid or distributed as aforesaid against the person or persons receiving that sum.

(3) (a) If the deceased person dies intestate, any sum payable on death may be paid or distributed without letters of administration by the Minister to or among such persons as appear to him, upon such evidence as he may deem satisfactory to be beneficially entitled to receive that sum, whether as next-of-kin or otherwise according to law or as creditors (including any person entitled to be paid or repaid the funeral expenses of the deceased person), or may be paid or distributed to or among such of the said persons as the Minister thinks fit and that to the exclusion of all others.

(b) In the case of the illegitimacy of the deceased person or of his children such person as in the opinion of the Minister would have been entitled to the sum payable on death if the deceased person or his children had been legitimate may for the purposes of this paragraph be treated as a person beneficially entitled thereto.

(4) The receipt of any person of the age of 16 years or upwards for any sum paid in accordance with these Regulations shall be a good discharge to the Minister for the sum so paid.

(5) Where any person who is a child under the age of 16 years is entitled to receive any sum payable on death in accordance with the provisions of these Regulations and it is proved to the satisfaction of the Minister that the sum is needed for the benefit of such child, the Minister may pay the sum or any part thereof to any person who may satisfy him that the person will apply such money for the benefit of such child, and the receipt of such person shall be a good discharge to the Minister for the amount so paid.

(6) The Minister upon making any payment in accordance with this Part of these Regulations shall be discharged from all liability in respect of any sum or sums so paid.

PART VI.MISCELLANEOUS.

23 Notification of change of residence.

23. Where a person who is entitled to or has applied for a children's allowance changes his place of residence, he shall, within seven days after such change of residence, notify the Minister thereof.

24 Notification of loss or destruction of allowance book.

24. Where a book of children's allowance orders has been lost or destroyed, the person to whom the book was issued shall notify the Minister immediately of such loss or destruction, and the Minister may, subject to such conditions as he thinks fit, issue a new book to that person.

25 Return of allowance books.

25. Any person to whom a book of children's allowance orders has been issued shall, on demand, return the book to the Minister.

26 Mode of sending notices.

26. Any notice or other document required or authorised under these Regulations to be sent to any person may be sent by post addressed to that person at his ordinary address.

27 Temporary provisions

27. Notwithstanding anything in these Regulations —

(a) if on the 1st day of July, 1952, a person is already entitled to a children's allowance or becomes on or after that date entitled to a children's allowance in respect of a payment period, the claim made by him from which derives —

(i) the payment period current for him on the 1st day of July, 1952, or

(ii) such payment period commencing after the 1st day of July, 1952, as is appointed for him,

shall be regarded as a claim duly made, on the expiration of the said payment period, for the purposes of these Regulations,

(b) where payment periods as at both subparagraph (i) and subparagraph (ii) of the immediately preceding paragraph are appointed for a person, the claim made by him from which the later of the payment periods derives shall be regarded as a claim duly made, at the expiration of the said later payment period, for the purposes of these Regulations.

(c) in the case of a claim accepted under paragraph (a) or (b) of this Regulation, a children's allowance awarded in respect of such claim shall commence to accrue on the expiration of the relevant payment period or payment periods,

(d) the Regulations of 1946 shall be deemed to continue in force for the purposes of claims for children's allowances made after the commencement of these Regulations in relation to qualifying dates which occurred before such commencement,

(e) the forms prescribed in the Regulations of 1946 may be used until the forms prescribed by these Regulations are provided.

28 Revocation of Regulations of 1946.

28. The Regulations of 1946 are hereby revoked.

GIVEN under my Official Seal, this 1st day of July, 1952.

(Signed) SEAMAS O RIAIN,

Minister for Social Welfare.

In pursuance of subsection (2) of section 20 of the Children's Allowances Act, 1944 (No. 2 of 1944), I hereby consent to the making of Part III of these Regulations.

(Signed) ERSKINE H. CHILDERS,

Minister for Posts and Telegraphs.

SCHEDULE.

FORM No. 1.

CLAIM FOR A CHILDREN'S ALLOWANCE.

1. Full Name of Claimant.....................................	1. Surname............................................................ .........
(in BLOCK CAPITALS)
	Christian Names....................................................... ............................................................ ........................
2. (a) Full Postal Address.	2.(a)............................................................ .....................
(b) County in which you actually live.	(b)............................................................ .....................
3. Have you previously claimed a Children's Allowance? If so, state:—	3. ............................................................ ........................
(a) Claim Number.	(a)............................................................ ....................
(b) When the claim was made.	(b)............................................................ ....................
(c) The result of the claim.	(c)............................................................ ....................
4. (a) Full Address of the local Post Office at which you desire that the allowance should be paid.	4. (a)............................................................ ...................
OR	OR
(b) If you desire to lodge the allowance to the credit of your Bank account, give particulars opposite.	(b) Name of Bank.......................................................
Branch of Bank....................................................
5. If you desire to nominate the mother of the children or some other responsible person to receive the allowance on your behalf, state:—	5.
(a) Name and address of person nominated.	(a)............................................................ ..................
(b) Relationship of person nominated to the children.	(b)............................................................ .................
(c) Does the person nominated reside with the children?	(c)............................................................ .................
(d) Is the person nominated over the age of 18 years?	(d)............................................................ ................
(e) If the person nominated is not the mother or an immediate female relative of the children, give reasons for the nomination.	(e)............................................................ ................ ............................................................ ................ ............................................................ ................
THE PERSON NOMINATED MUST SIGN HERE.	Specimen signature of person nominated by claimant— ............................................................ .........................

6. What is your occupation?	6. ............................................................ ..........................
7. Are you married or single or widow or widower?	7. ............................................................ ..........................
(State which)
8. If you are a married woman and your husband is not residing with you, give his present address.	8. ............................................................ ......................... ............................................................ ..........................

9. PARTICULARS OF CHILDREN FOR WHOM THE ALLOWANCE IS CLAIMED:

Name of each child alive and under the age of 16 years, including the first child		Date of Birth (see Note at foot of page)			State how long each child has resided in the State	Claimant's relationship to child
Surname	Full Christian Names	Day	Month	Year
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)

10. (a) Has any other person previously claimed a Children's Allowance in respect of any of the children mentioned in Paragraph 9?

10. (a)............................................................ ................

(b) If so state the name and address of such person.

(b)............................................................ .................

............................................................ ................

11. If you are not the parent or stepparent of each child named in Paragraph 9 are you head of the household of which the children are members?

11. ............................................................ ........................

NOTE.-BIRTH CERTIFICATES IN RESPECT OF EACH CHILD SHOULD BE ATTACHED. Birth Certificates may be procured at a cost of 6d. each from the Registrar or Superintendent Registrar of the district in which the births were registered if applied for on special forms obtainable from the Registrar or Superintendent Registrar.

If there is difficulty in obtaining one or more of the required Birth Certificates, the Claim Form should be completed and forwarded with those available. The outstanding Birth Certificate(s) must be furnished as quickly as possible thereafter.

12. (a) Is every child named in Paragraph 9 residing with you?

12. (a)............................................................ ..................

(b) If the answer to (a) is "No" give the following particulars:—

Name of all children named in Paragragh 9 who are not residing with you	Date when children left your household	Where and with whom each such child is residing at present

13. (a) Give full name and address of the father and the mother of any child named in Paragraph 9 who is not your own child or your stepchild. (If both of the child's parents are dead, say so).	13. (a)............................................................ .................. ............................................................ .................. ............................................................ .................. ............................................................ .................
(b) State :—
(i) why each such child is residing with you;	(b) (i)............................................................ ........... ............................................................ ...........
(ii) how long each such child has been residing with you.	(ii)............................................................ .......... ............................................................ ..........
14. If any child named herein is resident in an Institution, state, as to each such child—
(a) Do you contribute towards the child's maintenance?	(a)............................................................ ...............
(b) If so, to what extent?	(b)............................................................ ...............
15. I hereby claim a Children's Allowance on the basis of the children named in Paragraph 9 above, all of whom are living on this date.

I declare that to the best of my knowledge and belief all the information which I have given in this Claim is true and correct in every particular and that no other person is claiming a Children's Allowance in respect of any of these children.

The Signature should be the Claimant's usual signature.

Claimant's Signature......................................................

(or Mark if unable to write)

Date.............................................

This Form must be signed by the Claimant and not by a Nominee.

This Certificate must be Signed by a Person Qualified as Shown Opposite	Person Qualified to Certify.
	I hereby certify (i) that the claimant is known to me personally: (ii) that when this form was produced to me, the names of*..................children were entered in Paragraph 9 and (iii) that all the statements in this claim are true to be the best of my knowledge and belief.
(2) A Barrister or Solicitor.
(3) A Minister of Religion (stating Denomination and address of place of worship).
The signature (or mark) above was made or acknowledged personally by the Claimant in my presence this ............ day of........................... 195........	(4) A Member of the Oireachtas.
(5)A Registered Medical Practitioner.
Signature of Certifier..................................................	(6) A Professor or Lecturer at a University or a Teacher of a Primary or Secondary School (stating the name and address of University or School).
Address............................................................ .............	(7) A Bank Manager.
............................................................ ............................	(8) *A Member of the Garda Síochána not below the rank of Sergeant.
Qualification............................................................ .....	(9) *The Clerk or any Member of a Local Authority.
	(10) *A Home Assistance Officer.
	*If an official Stamp denoting the Office is in use it should be impressed on the Certificate.

* State Number

WARNING

Any claimant who in his claim makes any statement or representation which is false or misleading in a material respect or who conceals any material fact, renders himself liable to prosecution under the Acts for an offence punishable on summary conviction by a fine not exceeding £25 or by imprisonment for any term not exceeding three months.

Whenever, subsequent to the making of this Claim, a change occurs in the number of qualified children claimed for—whether by way of increase or decrease in that number—the claimant is required to notify the Department immediately. Forms for this purpose are obtainable at any Post Office. The original allowance awarded will then be revised with effect from the first day of the month following that in which the change occurred.

FORM No. 2.

CLAIM IN RESPECT OF ADDITIONAL QUALIFIED CHILDREN.

Claim to be made by Head of Family who has already been awarded a children's Allowance.

1. Particulars of Additional qualified children:—

Name of each additional child		Date of Birth			Claimant's relationship to a child
Surname	Full Christian Name(s)	Day	Month	Year
	(1)
	(2)

Note.—Birth or Baptismal Certificates must be attached in respect of each Child.

2. Claim Number.	2. ............................................................ ........................
3. Claimant's full name and address. (in Block Capitals)	3. ............................................................ ....................... ............................................................ ...................... County of Residence..............................................
4. If any child named herein was NOT born into your family since the date of your last claim, state—	4.
(a) the full name and address of the person (or institution) with whom (or in which) each such child formerly resided;	(a)............................................................ .................. ............................................................ ................. ............................................................ .................
(b) the full name and address of the father and the mother of any such child who is not your own child or your stepchild. (If both of the child's parents are dead, say so);	(b)............................................................ ................. ............................................................ ................ ............................................................ ................ ............................................................ ................
(c) the reason why each such child has been admitted to your family;	(c)............................................................ ................. ............................................................ .................
(d) how long each such child has been residing and will continue to reside with you.	(d)............................................................ ................. ............................................................ .................
5. If any child named herein is NOT residing with you, state where and with whom the child is residing.	5. ............................................................ .......................... ............................................................ .......................... ............................................................ ..........................

6. (a) Is any child named herein an inmate of an Institution?	6. (a)............................................................ .....................
(b) If the answer is "Yes"—	(b)
(i) state the name of the child and the name and address of the Institution in each case;	(i) ............................................................ ........... ............................................................ ........... ............................................................ ........... ............................................................ ...........
(ii) to what extent do you contribute towards the cost of the child's maintenance in such Institution?	(ii)............................................................ ..........
(iii) would each such child otherwise normally reside with you?	(iii)............................................................ .........

7. I hereby claim an additional Children's Allowance on the basis of the child(ren) named in Paragraph I who is/are living on this date.

I declare that to the best of my knowledge and belief all the information which I have given in this claim is true and correct in every particular and that no other person is claiming a Children's Allowance in respect of the child(ren) named in Paragraph I.

Claimant's Signature (or mark, if unable to write)............................................................ .........................................

(The signature should be the claimant's usual signature.)

Date..................................................

This Certificate must be signed by a Person Qualified as shown Opposite	Person Qualified to Certify.
	I hereby certify (i) that the claimant is known to me personally: (ii) that when this form was produced to me, the names of..................children were entered in Paragraph 9 and (iii) that all the statements in this claim are true to be the best of my knowledge and belief.
(2) A Barrister or Solicitor.
(3) A Minister of Religion (stating Denomination and address of place pf worship).
(4) A Member of the Oireachtas.
(5) A Registered Medical Practitioner.
The signature (or mark) above was made or acknowledged personally by the claimant in my presence this ................ day of................................ 195.......	(6) A Professor or Lecturer at a University or a Teacher of a Primary or Secondary School (stating the name and address of University or School).
	(7) A Bank Manager.
(8) *A Member of the Garda Síochána not below the rank of Sergeant.
Signature of Certifier ........................................	(9) *The Clerk or any Member of a Local Authority.
Address............................................................ ....	(10) *A Home Assistance Officer.
.........................................................	*If an official stamp denoting the office is in use it should be impressed on the certificate.
Qualification ................................................

WARNING