Check your details
| Your name | Miriam Smith | Change this |
| Date of birth | 24 March 1955 | Change this |
| Email address | m.smith@inter.net | Change this |
| Telephone number | 0191 123 1234 | Change this |
| Are you living permanently in a care home? | No | Change this |
| Are you currently in hospital? | No | Change this |
| Do you have a job? | Change this | |
| Are you in full time education? | No | Change this |
| Do you receive a pension? | Yes | Change this |
| Do you receive pension credit? | No | Change this |
| Which pensions do you receive? | Private pension | Change this |
| How much do you receive for your private pension? | £123 per week | Change this |
| Do you receive any social security benefits? | No | Change this |
| Are you looking after someone but can’t get carers allowance because of another benefit? | No | Change this |
| Does anyone receive carers allowance for looking after you? | No | Change this |
| Do you receive any other money? | No | Change this |