SURNAME OF UASC

FIRST/OTHER NAMES

HO (OR MEU) NUMBER

Care First No.

STATED DOB

CURRENTLY REGARDED AS AN ADULT?

YES/NO

SUBJECT TO PREV AGE ASSESSMENT?

YES/NO

SW (lead) UNDERTAKING ASSESSMENT

DATE ASSESSMENT STARTED

DATE ASSESSMENT COMPLETED/SIGNED OFF

OUTCOME

AGE RAISED/CONFIRMED/LOWERED

IF INCREASED

Remains u-16/Over 16 / over 18

IF LOWERED REMAINS OVER 16

YES/NO

REVISED AGE

AGE:

DoB

IMPLEMENTATION DATE OF ANY CHANGE

PLACEMENT CHANGE TO BE MADE

YES/NO

REMAINS IN CARE?

YES/NO

RETAINS LEAVING CARE ENTITLEMENT?

YES/NO

ASYLUM/IMMIGRATION STATUS

No Decision/DLR/Other…..

DATE HOME OFFICE NOTIFIED

Admin only

DATE NRUC CHANGED

DATE CARE FIRST CHANGED nb enter on Life Events whatever outcome

DATE AMENDED Annex A info