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Example 2
Mary Bloggs is a mother of two young children. Her only income, other than child benefit, is a weekly One Parent Family Payment of €204.40. She is living in accommodation rented from the local authority for which she pays €25 per week. She has no assets and is applying for legal aid. Her financial eligibility and contribution are assessed as follows:
 |  | INCOME ASSESSMENT FORM |  |  |
 |  |  |  |  |
 |  |  |  |  |
| NAME: Mary Bloggs | | | REF. NO.: | |
| Allowances | | | Income | |
| | | | | |
| Nature of allowance | Max allowance | Amount allowed | Source | Amount |
| |  |  | | |
| Spouse/partner | € 3, 500 | Nil | Employment/Pension | Nil |
| Each dependant | € 1, 600 | €3,200 | | |
| Child care | € 6, 000 | Nil | Maintenance | Nil |
| Social insurance | Full | Nil | | |
| Income tax | Full | Nil | Social Welfare | €10,628.80 |
| Accommodation costs | € 8, 000 | €1,300 |  | |
| Ex-gratia payment | € 1, 040 | Nil | Business | Nil |
| | | | | |
| | | | Benefit in Kind | Nil |
| | | | | |
| | | | Other | Nil |
| Total: |  | €4,500 | Total: | €10,628.80 |
| | | | | |
| |  |  |  | |
| Gross Income | €10,628.80 |  |  | |
| |  |  |  | |
| Less allowances | €4,500.00 |  |  | |
| |  |  |  | |
| Disposable income | €6,128.80 | Less €11, 500 = | N/A | = A |
| |  |  |  | |
| |  |  |  | |
| Legal advice contribution | € | (A) x 10% = | €10 | |
| (minimum €10, maximum €150) |  |  | |  |
| |  |  |  | |
| Legal aid contribution | € (A) | x 25% plus €50 = | €50 | |
| (minimum €50) |  |  |  | |
| |  |  |  | |
| Capital contribution |  |  | Nil | |
| |  |  |  | |
| Total contribution |  |  | €50 | |
| |  |  |  | |
| | | | | |
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