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<?xml version="1.0" encoding="UTF-8"?>
<!--Sample XML file generated by XMLSpy v2010 rel. 3 sp1 (http://www.altova.com)-->
<ValidateClaim xsi:schemaLocation="http://www.autotdd.com/ca Conversation%20v2_1%202010-07-16.xsd" xmlns="http://www.autotdd.com/ca" xmlns:n1="http://www.autotdd.com/ca" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
	<piid>String</piid>
	<newClaimantData>true</newClaimantData>
	<ClaimantData>
		<ClaimantNINO>CL800119A</ClaimantNINO>
		<ClaimantNameDetails>
			<PersonNameTitle>MR</PersonNameTitle>
			<PersonGivenName>BREAK</PersonGivenName>
			<PersonFamilyName>IN-CARE</PersonFamilyName>
			<PersonNameSuffix>BSC</PersonNameSuffix>
			<PersonRequestedName>BREAKY</PersonRequestedName>
		</ClaimantNameDetails>
		<ClaimantBirthDate>
			<PersonBirthDate>1958-02-10</PersonBirthDate>
			<VerificationLevel>Level 1</VerificationLevel>
		</ClaimantBirthDate>
		<ClaimantMaritalStatus>
			<MaritalStatus>Married</MaritalStatus>
			<VerificationLevel>Level 1</VerificationLevel>
		</ClaimantMaritalStatus>
		<ClaimantGenderAtRegistration>1 = Male</ClaimantGenderAtRegistration>
		<ClaimantGenderCurrent>1 = Male</ClaimantGenderCurrent>
		<ClaimantNationality>GB</ClaimantNationality>
		<ClaimantContactDetails>
			<PreferredLanguages>en</PreferredLanguages>
			<Email n1:EmailUse="work" n1:EmailPreferred="yes">
				<EmailAddress>'breaks@care.com'</EmailAddress>
			</Email>
		</ClaimantContactDetails>
		<ClaimantAddress>
			<Line1>1 BREAK</Line1>
			<Line2>IN-CARE</Line2>
			<PostCode>BC1 1AA</PostCode>
		</ClaimantAddress>
	</ClaimantData>
	<newClaimData>true</newClaimData>
	<ClaimData>
		<ClaimStartDate>2010-05-06</ClaimStartDate>
		<ClaimNinoKnown>yes</ClaimNinoKnown>
		<ClaimPrevious>no</ClaimPrevious>
		<ClaimOverseas>no</ClaimOverseas>
		<ClaimEUArea>yes</ClaimEUArea>
		<ClaimEUDependantChildren>no</ClaimEUDependantChildren>
		<ClaimAlwaysUK>yes</ClaimAlwaysUK>
		<ClaimCurrentResidentUK>yes</ClaimCurrentResidentUK>
		<ClaimPartnerExists>yes</ClaimPartnerExists>
		<ClaimPartnerExistsDate>1990-05-10</ClaimPartnerExistsDate>
		<ClaimRelationToCarer>Husband</ClaimRelationToCarer>
		<ClaimPaidCare>no</ClaimPaidCare>
		<ClaimRivalCarer>no</ClaimRivalCarer>
		<Claim35Hours>yes</Claim35Hours>
		<ClaimBreakInCare>yes</ClaimBreakInCare>
		<ClaimBreaks>
			<BreakInCare>
				<BICFromDate>2010-05-30</BICFromDate>
				<BICToDate>2010-06-13</BICToDate>
				<BICReason>Hospitalisation</BICReason>
				<BICType>Hospital</BICType>
			</BreakInCare>
			<BreakInCare>
				<BICFromDate>2010-06-21</BICFromDate>
				<BICToDate>2010-06-30</BICToDate>
				<BICReason>Hospitalisation</BICReason>
				<BICType>Hospital</BICType>
			</BreakInCare>
		</ClaimBreaks>
		<ClaimPrior35Hours>yes</ClaimPrior35Hours>
		<ClaimPrior35HoursDate>2010-05-17</ClaimPrior35HoursDate>
		<ClaimPriorBreakInCare>no</ClaimPriorBreakInCare>
		<ClaimDependantAwayFromHome>no</ClaimDependantAwayFromHome>
		<ClaimEducationFullTime>no</ClaimEducationFullTime>
		<ClaimEmployment>no</ClaimEmployment>
		<ClaimRentalIncome>no</ClaimRentalIncome>
		<ClaimPaidClass2NIC>no</ClaimPaidClass2NIC>
		<ClaimSelfEmployed>no</ClaimSelfEmployed>
	</ClaimData>
	<newPartnerData>true</newPartnerData>
	<PartnerData>
		<PartnerNINO>DP800119A</PartnerNINO>
		<PartnerNameDetails>
			<PersonNameTitle>MRS</PersonNameTitle>
			<PersonGivenName>MANDY</PersonGivenName>
			<PersonFamilyName>IN-CARE</PersonFamilyName>
		</PartnerNameDetails>
		<PartnerBirthDate>
			<PersonBirthDate>1974-12-01</PersonBirthDate>
			<VerificationLevel>Level 1</VerificationLevel>
		</PartnerBirthDate>
		<PartnerMaritalStatus>
			<MaritalStatus>Married</MaritalStatus>
			<VerificationLevel>Level 1</VerificationLevel>
		</PartnerMaritalStatus>
		<PartnerGenderAtRegistration>2 = Female</PartnerGenderAtRegistration>
		<PartnerGenderCurrent>2 = Female</PartnerGenderCurrent>
		<PartnerNationality>GB</PartnerNationality>
		<PartnerContactDetails>
			<PreferredLanguages>en</PreferredLanguages>
		</PartnerContactDetails>
		<PartnerAddress>
			<Line1>1 BREAK</Line1>
			<Line2>IN-CARE</Line2>
			<PostCode>BC1 1AA</PostCode>
		</PartnerAddress>
	</PartnerData>
	<newDependantData>true</newDependantData>
	<DependantData>
		<DependantNINO>DP800119A</DependantNINO>
		<DependantNameDetails>
			<PersonNameTitle>MRS</PersonNameTitle>
			<PersonGivenName>MANDY</PersonGivenName>
			<PersonFamilyName>IN-CARE</PersonFamilyName>
		</DependantNameDetails>
		<DependantBirthDate>
			<PersonBirthDate>1974-12-01</PersonBirthDate>
			<VerificationLevel>Level 1</VerificationLevel>
		</DependantBirthDate>
		<DependantMaritalStatus>
			<MaritalStatus>Married</MaritalStatus>
			<VerificationLevel>Level 1</VerificationLevel>
		</DependantMaritalStatus>
		<DependantGenderAtRegistration>2 = Female</DependantGenderAtRegistration>
		<DependantGenderCurrent>2 = Female</DependantGenderCurrent>
		<DependantNationality>GB</DependantNationality>
		<DependantContactDetails>
			<PreferredLanguages>en</PreferredLanguages>
		</DependantContactDetails>
		<DependantAddress>
			<Line1>1 BREAK</Line1>
			<Line2>IN-CARE</Line2>
			<PostCode>BC1 1AA</PostCode>
		</DependantAddress>
	</DependantData>
	<newPaidCareData>false</newPaidCareData>
	<newRivalCarerData>false</newRivalCarerData>
	<newStatementData>true</newStatementData>
	<StatementData>
		<StatementType>SignedBySelf</StatementType>
		<StatementRole>Self</StatementRole>
		<StatementSignature>X</StatementSignature>
		<StatementDate>2010-06-28</StatementDate>
		<StatementHoursConfirmed>yes</StatementHoursConfirmed>
		<StatementHoursUnconfirmed>no</StatementHoursUnconfirmed>
		<StatementReason/>
	</StatementData>
	<newResidenceData>false</newResidenceData>
	<newEducationData>false</newEducationData>
	<newEmploymentData>false</newEmploymentData>
	<newExpensesData>false</newExpensesData>
	<newSelfEmpData>false</newSelfEmpData>
	<newOtherMoneyData>false</newOtherMoneyData>
	<newPaymentData>true</newPaymentData>
	<PaymentData>
		<PaymentPeriodicity>Weekly</PaymentPeriodicity>
		<PaymentAccountHolder>MR B IN-CARE</PaymentAccountHolder>
		<PaymentBankName>MIDLAND BANK</PaymentBankName>
		<PaymentSortCode>212121</PaymentSortCode>
		<PaymentAccountNumber>12345678</PaymentAccountNumber>
		<PaymentAlignAccount>yes</PaymentAlignAccount>
	</PaymentData>
	<newConsentData>true</newConsentData>
	<ConsentData>
		<ConsentAgreeEmployer>no</ConsentAgreeEmployer>
		<ConsentAgreeOthers>yes</ConsentAgreeOthers>
		<ConsentSignature>GOT ONE</ConsentSignature>
		<ConsentDate>2010-06-28</ConsentDate>
	</ConsentData>
</ValidateClaim>
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