You’ll need to include your Test Period dates in the claim form. Your Test Period is the 66 weeks before the week you expect to have your baby. Use the Test Period calculator to find out these dates.

Before you start this form

If you’re using a mobile phone or tablet

You cannot complete the form using a mobile phone or tablet. You have to either:

use a desktop or laptop computer
print the form and complete it by hand

If you’re using a desktop or laptop computer

Use a PDF reader to open and fill in this form. You can download a free PDF reader online.

If you are using screen reader software to access the form, we recommend that you review all of the notes and the questions on the form before you complete it. As you complete the form, you will be guided through the questions based on the responses you provide.

Do not use your computer’s browser or, if you are an Apple Macintosh user, the Preview application.

You can save data typed into this form if you use a PDF reader. This means that you do not have to fill in the form in one session.

There are reliability issues with some assistive software, which may mean the form will not save properly.

This form will only save if it is both:

saved onto your computer
opened in a recent version of PDF reader

The form will not save in:

versions of Acrobat Reader older than version XI
some other PDF readers, for example Preview on a Mac or Foxit on a PC

Help using this PDF claim form

For help and advice on the information you need to put on the form or about the benefit you want to claim, contact the Maternity Allowance line at Jobcentre Plus.

Contact the DWP Online Helpdesk, if you are having technical difficulties:

downloading the form
navigating around the form
printing the form

DWP online helpdesk
Email dwponline.helpdesk@dwp.gov.uk
Telephone 0800 169 0154
Monday to Friday 8am to 6pm
Closed weekends and all public and bank holidays
Find out about call charges

Order a printed claim form

If you cannot download or print the claim form, you can ask for a form to be posted to you.

This service is only available if you live in England, Scotland and Wales. There is a different process in Northern Ireland.

Find out how to ask for a claim form in Northern Ireland

Order a claim form

If you need this form in a different format

For other formats, such as braille, large print or audio CD, contact Jobcentre Plus.

Published 1 October 2013
Last updated 19 April 2024 + show all updates

19 April 2024
Updated the Maternity Allowance claim form and also the notes sheet for the Maternity Allowance claim form (English and Welsh).
3 April 2024
Updated the Test Period tables. They now cover the period from August 2023 to December 2025.
23 November 2023
Updated Maternity Allowance claim form and notes sheet for the Maternity Allowance claim form (English and Welsh), with new return address.
3 July 2023
Removed the message that there was a problem with the 'order a Maternity Allowance claim form online' service on 7 June 2023.
19 June 2023
Added a message that there was a problem with the 'order a Maternity Allowance claim form online' service from 2.45pm until 6.15pm on Wednesday 7 June 2023. We may not have received your request if you ordered a claim form during this time. If you have not received your claim form, please submit a new request.
1 March 2023
Corrected the example in the HTML version of the test period table. In the line 'The week that includes the date you expect to have your baby (column 1): 12 February 2021 to 18 February 2023', 12 February 2021 should have been 12 February 2023.
27 January 2023
Added new versions of the Maternity Allowance claim forms in English and Welsh.
21 November 2022
Added Maternity Allowance - Test Period tables from October 2022 to December 2024 (HTML and PDF) - Welsh.
17 October 2022
Added Test Period tables from October 2022 to December 2024 (HTML and PDF).
10 September 2021
Added information on how to order a claim form in Northern Ireland.
3 September 2021
Added link to the Test Period calculator where you can check your Test Period dates. You must include these dates in your Maternity Allowance application form.
16 August 2021
Updated the Test Period table with dates for the week that includes the date you expect to have your baby up to December 2022.
1 October 2020
Updated the Test Period table with dates for the week that includes the date you expect to have your baby up to December 2021.
11 March 2020
Added accessible version of test period table. It has also been updated following feedback of some incorrect dates.
28 August 2019
Added Test Period tables for 2019 to 2020.
26 April 2019
Added Test Period tables from 2018 to 2019.
25 April 2019
Updated the following forms: 'Notes sheet for the Maternity Allowance claim form' (now dated 12/18), 'Welsh: Lwfans Mamolaeth MA1W' (now dated 05/18), and 'Welsh: Lwfans Mamolaeth taflen nodiadau' (now dated 12/18). Also published a new claim form, 'Welsh: Ffurflen hawlio Lwfans Mamolaeth, gallwch ei llenwi ar y sgrîn ac yna ei hargraffu' (dated 05/18).
3 May 2018
Published an English version of the notes sheet, that was previously part of the claim form, as a separate document.
3 October 2017
Updated the Welsh version of the Maternity Allowance claim form with new test period tables covering 2018 to 2019.
2 October 2017
Updated the English versions of the Maternity Allowance claim form with new test period tables covering 2018 to 2019.
4 May 2016
Replaced all 3 versions with March 2016 editions.
10 October 2014
Replaced the interactive and print versions of the form with October 2014 editions.
1 October 2013
First published.

Maternity Allowance claim form

Applies to England, Scotland and Wales

Documents