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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>CL100102A</ClaimantNINO>
		<ClaimantNameDetails>
			<PersonNameTitle>MR</PersonNameTitle>
			<PersonGivenName>ADRIAN ROBERT</PersonGivenName>
			<PersonFamilyName>HEPWORTH</PersonFamilyName>
			<PersonNameSuffix>BSC</PersonNameSuffix>
			<PersonRequestedName>BOB HEPWORTH</PersonRequestedName>
		</ClaimantNameDetails>
		<ClaimantBirthDate>
			<PersonBirthDate>1970-08-13</PersonBirthDate>
			<VerificationLevel>Level 1</VerificationLevel>
		</ClaimantBirthDate>
		<ClaimantDeathDate>
			<PersonDeathDate>3000-01-01</PersonDeathDate>
			<VerificationLevel>Level 0</VerificationLevel>
		</ClaimantDeathDate>
		<ClaimantMaritalStatus>
			<MaritalStatus>Single</MaritalStatus>
			<VerificationLevel>Level 1</VerificationLevel>
		</ClaimantMaritalStatus>
		<ClaimantGenderAtRegistration>1 = Male</ClaimantGenderAtRegistration>
		<ClaimantGenderCurrent>1 = Male</ClaimantGenderCurrent>
		<ClaimantNationality>GB</ClaimantNationality>
		<ClaimantContactDetails>
			<PreferredLanguages>en</PreferredLanguages>
			<Telephone n1:TelMobile="no" n1:TelUse="home" n1:TelPreferred="yes">
				<TelNationalNumber>01937843786</TelNationalNumber>
				<TelExtensionNumber>0</TelExtensionNumber>
				<TelCountryCode>44</TelCountryCode>
			</Telephone>
		</ClaimantContactDetails>
		<ClaimantAddress>
			<Line1>5 LONSDALE MEADOWS</Line1>
			<Line2>BOSTON SPA</Line2>
			<PostCode>LS23 6DQ</PostCode>
		</ClaimantAddress>
	</ClaimantData>
	<newClaimData>true</newClaimData>
	<ClaimData>
		<ClaimStartDate>2010-01-06</ClaimStartDate>
		<ClaimNinoKnown>yes</ClaimNinoKnown>
		<ClaimPrevious>no</ClaimPrevious>
		<ClaimPreviousPaid>no</ClaimPreviousPaid>
		<ClaimOverseas>no</ClaimOverseas>
		<ClaimAlwaysUK>yes</ClaimAlwaysUK>
		<ClaimCurrentResidentUK>yes</ClaimCurrentResidentUK>
		<ClaimPartnerExists>no</ClaimPartnerExists>
		<ClaimRelationToCarer>Son</ClaimRelationToCarer>
		<ClaimPaidCare>no</ClaimPaidCare>
		<ClaimRivalCarer>no</ClaimRivalCarer>
		<Claim35Hours>yes</Claim35Hours>
		<ClaimBreakInCare>no</ClaimBreakInCare>
		<ClaimPrior35Hours>no</ClaimPrior35Hours>
		<ClaimEducationFullTime>no</ClaimEducationFullTime>
		<ClaimEmployment>no</ClaimEmployment>
		<ClaimRentalIncome>no</ClaimRentalIncome>
		<ClaimPaidClass2NIC>no</ClaimPaidClass2NIC>
		<ClaimSelfEmployed>no</ClaimSelfEmployed>
	</ClaimData>
	<newPartnerData>true</newPartnerData>
	<newDependantData>true</newDependantData>
	<DependantData>
		<DependantNINO>DP100102A</DependantNINO>
		<DependantNameDetails>
			<PersonNameTitle>MRS</PersonNameTitle>
			<PersonGivenName>MAUREEN</PersonGivenName>
			<PersonFamilyName>HEPWORTH</PersonFamilyName>
			<PersonNameSuffix> </PersonNameSuffix>
			<PersonRequestedName> </PersonRequestedName>
		</DependantNameDetails>
		<DependantBirthDate>
			<PersonBirthDate>1920-05-01</PersonBirthDate>
			<VerificationLevel>Level 1</VerificationLevel>
		</DependantBirthDate>
		<DependantMaritalStatus>
			<MaritalStatus>Widowed</MaritalStatus>
			<VerificationLevel>Level 1</VerificationLevel>
		</DependantMaritalStatus>
		<DependantGenderAtRegistration>2 = Female</DependantGenderAtRegistration>
		<DependantGenderCurrent>2 = Female</DependantGenderCurrent>
		<DependantNationality>GB</DependantNationality>
		<DependantAddress>
			<Line1>9 HALL MEWS</Line1>
			<Line2>BOSTON SPA</Line2>
			<PostCode>LS23 6QB</PostCode>
		</DependantAddress>
	</DependantData>
	<newPaidCareData>true</newPaidCareData>
	<newRivalCarerData>true</newRivalCarerData>
	<newStatementData>true</newStatementData>
	<StatementData>
		<StatementType>SignedBySelf</StatementType>
		<StatementRole>Self</StatementRole>
		<StatementSignature/>
		<StatementDate>2010-05-10</StatementDate>
		<StatementHoursConfirmed>yes</StatementHoursConfirmed>
		<StatementHoursUnconfirmed>no</StatementHoursUnconfirmed>
		<StatementReason/>
	</StatementData>
	<newResidenceData>true</newResidenceData>
	<ResidenceData>
		<ResidenceNormallyGB>yes</ResidenceNormallyGB>
		<ResidenceNormalCountry/>
		<ResidenceCurrentlyGB>yes</ResidenceCurrentlyGB>
		<Residence4WeeksOutsideGB>no</Residence4WeeksOutsideGB>
		<ResidencePrior12Months>no</ResidencePrior12Months>
	</ResidenceData>
	<newEducationData>true</newEducationData>
	<newEmploymentData>false</newEmploymentData>
	<newExpensesData>false</newExpensesData>
	<newSelfEmpData>false</newSelfEmpData>
	<newOtherMoneyData>false</newOtherMoneyData>
	<newPaymentData>false</newPaymentData>
	<newConsentData>true</newConsentData>
	<ConsentData>
		<ConsentAgreeEmployer>yes</ConsentAgreeEmployer>
		<ConsentAgreeOthers>yes</ConsentAgreeOthers>
		<ConsentSignature></ConsentSignature>
		<ConsentDate>2010-05-10</ConsentDate>
	</ConsentData>
</ValidateClaim>
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