Work Search and Work Availability Doubt		
UC190 V1.0		

Part 1 - About the Participant	
	
Title			NI number		
					
Surname			Other names		
	
Part 2 - Reasons for referral 	
Please tell us below as much as you can about why you think the participant may not be available for work or undertaking agreed work search activities.	

		
	
Part 3 - Provider details	
Provider name			Provider Address (correspondence)		
Adviser name					
Phone number					
Email address of designated inbox			Date		
Subcontractors only (Prime Provider name)					

UC190 V1.0