S.I. No. 387/1952:

UNEMPLOYMENT ASSISTANCE (APPLICATION FOR ASSISTANCE REGULATIONS) (AMENDMENT) (NO. 2) ORDER, 1952.

UNEMPLOYMENT ASSISTANCE (APPLICATION FOR ASSISTANCE REGULATIONS) (AMENDMENT) (NO. 2) ORDER, 1952.

The Minister for Social Welfare, in exercise of the powers conferred on him by subsection (1) of section 7 of the Unemployment Assistance Act, 1933 (No. 46 of 1933), as adapted by the Social Welfare (Transfer of Departmental Administration and Ministerial Functions) (No. 1) Order, 1947 (S. R. & O., No. 18 of 1947), hereby orders as follows :

1. This Order may be cited as the Unemployment Assistance (Application for Assistance Regulations) (Amendment) (No. 2) Order, 1952.

2. This Order shall come into operation on the 5th day of January, 1953.

3. The Interpretation Act, 1937 (No. 38 of 1937), applies to this Order.

4. The First Schedule to the Unemployment Assistance (Application for Assistance Regulations) Order, 1934 (S. R. & O., No. 126 of 1934), as amended by the Unemployment Assistance (Application for Assistance Regulations) (Amendment) Order, 1935 (S. R. & O., No. 575 of 1935), the Unemployment Assistance (Application for Assistance Regulations) (Amendment) Order, 1948 ( S.I. No. 411 of 1948 ), and the Unemployment Assistance (Application for Assistance Regulations) (Amendment) Order, 1952 ( S.I. No. 169 of 1952 ), is hereby further amended by the substitution for the Form set out therein of the Form set out in the Schedule to this Order.

5. Subparagraph (a) of paragraph (1) of Regulation V of the Unemployment Assistance (Application for Assistance Regulations) Order, 1934 (S. R. & O., No. 126 of 1934), is hereby amended by the insertion after the word " Order " of the words " or in such other form as the Minister may direct or may accept as sufficient ".

SCHEDULE.

Application for Unemployment Assistance

I............................................................ ............................................................ ............................................................ ...

of............................................................ ............................................................ ............................................................ .

.hereby apply for unemployment assistance. I declare that :--

(1) My date of birth is............................................................ ............................................................ .......................

(2) I was last employed by :

(i) Name............................................................ ............................................................ ...........................................

(ii) Address............................................................ ............................................................ .....................................

(iii) Business of Employer............................................................ ............................................................ ............

(iv) Capacity in which employed............................................................ ............................................................ .

(v) From............................................................ ....to............................................................ ...................................

(vi) Foreman, Department or Check No............................................................ ..................................................

(3) I am the person named as the holder of the qualification certificate now delivered by me ;

(4) Since my qualification certificate was issued to me I have not done anything and no change of circumstances or other event has occurred which would invalidate such certificate or would disentitle me to hold such certificate ;

(5) I am unemployed, capable of, available for and genuinely seeking but unable to obtain employment suitable for me having regard to my age, sex, physique, education, normal occupation, place of residence and family circumstances ;

(6) I am not in receipt of or entitled to :

(i) a pension for blind persons under the Old Age Pensions Acts, 1908 to 1952 ;

(ii) any disability benefit or unemployment benefit under the Social Welfare Act, 1952 ;

Applicable to women applicants only.

(iii) any widow's (contributory) pension or maternity allowance under the Social Welfare Act, 1952 , or any widow's (non-contributory) pension under the Widows' and Orphans' Pensions Acts, 1935 to 1952.

(7) (i) During the past year I have ordinarily resided at the following address or addresses :--

(ii) During the past year I have been employed as follows :--

Signature of Applicant............................................................ ............................................................ .........................

Date of Signature............................................................ ............................................................ ..................................

CLAIM FOR INCREASE IN RESPECT OF DEPENDANTS.

A. MARRIED MAN claiming his WIFE as a dependant :

1. Wife's Christian Names............................................................ ............................................................ ................

2. Number of her Insurance Card (if any)............................................................ ..................................................

3. Is your wife living with you ?............................................................ ............................................................ .....

4. If she is not living with you, do you contribute to her maintenance and if so, how much?............................................................ ............................................................ .........................................

5. Where does she reside ?............................................................ ............................................................ .............

6. If your wife is claiming or in receipt of any benefit, pension, allowance or assistance, give particulars............................................................ ............................................................ ..................................

B. MARRIED WOMAN claiming her INVALIDED HUSBAND as a dependant :

1. Husband's Christian Names............................................................ ............................................................ ........

2. Number of his Insurance Card (if any)............................................................ ..................................................

3. Is your husband incapable of supporting himself ? If so, state reason............................................................ ............................................................ .........................................

4. Do you wholly or mainly maintain your husband ?............................................................ ............................

5. If your husband is claiming or in receipt of Disability Benefit or any pension, allowance or assistance, give particulars............................................................ ............................................................ .....

C. WIDOWER OR SINGLE MAN claiming as an adult dependant A FEMALE PERSON having the care of his child dependants :

1. Full Name of person having the care of your child dependants............................................................ .......

2. Number of her Insurance Card............................................................ ............................................................ ...

3. Her home address, if not resident in your household............................................................ ........................

4. Is she over 16 years of age ?............................................................ ............................................................ ......

5. Is she single, married or a widow ?............................................................ .......................................................

6. Is she wholly or mainly maintained by you?............................................................ ............................................................ ............................................

7. What weekly wages do you pay her ?............................................................ ..................................................

8. If she is claiming or in receipt of any benefit, pension, allowance or assistance, give particulars............................................................ ............................................................ ..................................

D. PERSON claiming as dependants A CHILD OR TWO CHILDREN under 16 years of age :

1. Particulars of children :--

2. Are you in receipt of Children's Allowances ? If so, state Claim Number shown on your Allowance Book............................................................ ............................................................ ............................................

3. State total number of children under 16 years of age in your household....................................................

4. Is any allowance (other than a Children's Allowance), benefit, pension or assistance payable, either to you or to any other person, in respect of any child who is in your household or who normally belongs to your household ? If so, give particulars............................................................ .......................

DECLARATION

I hereby declare that, to the best of my knowledge and belief, all the information given by me on this form in respect of persons claimed as my dependants is true in all respects and no other person is claiming any increase of benefit or assistance in respect of any of these persons. I undertake to notify the Local Officer of the Department of Social Welfare if any of the information furnished by me on this form ceases to be true.

*Signature ............................................Date............................................................ ......................

*If you are unable to write, your mark should be affixed and duly witnessed.

CONFIRMATION (See Note below)

The information given in this claim is correct to the best of my knowledge and belief.

Date............................................................ .................Signature............................................................ ........................

Address............................................................ ...........Description............................................................ .....................

Note.--The confirmation should be signed by one of the following : A Peace Commissioner ; a Barrister or Solicitor ; a Minister of Religion ; a Registered Medical Practitioner ; a Schoolmaster or Teacher of a day school ; a Home Assistance Officer ; a County, City, Borough or Urban District Councillor ; a Secretary or other responsible local representative of the Claimant's Trade Union.

Given under the Official Seal of the Minister for Social Welfare, this 31st day of December, 1952.

(Signed) W. MAGUIRE,

Secretary,

Department of Social Welfare.

A person authorised under Section 15 (1) of the Ministers and Secretaries Act, 1924 , to authenticate the Seal of the said Minister.