Section F - Self Employed (to be completed by you) Trading Name & Address Business Telephone Number Postcode Date trading commenced Were you working a minimum of 16 hours per week every week prior to your unemployment? Yes No If No, please provide a reason for this What is the reason for your unemployment? Have you totally and permanently ceased trading? Yes No If No, please provide details as to why Are you in receipt of any remuneration from this business? Yes No If please confirm details ‘Yes’, Do you still participate in anyway in the business? Yes No If please confirm details ‘Yes’, Your business accountant’s name Accountant’s address Section G - Additional Information
Section F - Self Employed (to be completed by you) Trading Name & Address Business Telephone Number Postcode Date trading commenced Were you working a minimum of 16 hours per week every week prior to your unemployment? Yes No If No, please provide a reason for this What is the reason for your unemployment? Have you totally and permanently ceased trading? If No, please provide details as to why Yes No Are you in receipt of any remuneration from this business? If ‘Yes’, please confirm details Yes No Do you still participate in anyway in the business? If ‘Yes’, please confirm details Yes No Your business accountant’s name Accountant’s address Section G - Additional Information
Covea-Claim-Form-Self-Emp-Unemp-Income-Protection.docx