Signature
Name
Name
Two of the Lords Commissioners of Her Majesty’s Treasury
Date
The Secretary of State concurs.
Signed by authority of the Secretary of State for Work and Pensions
Name
Minister of State
Department for Work and Pensions
Date
The Department for Social Development concurs.
Sealed with the Official Seal of the Department for Social Development on [date]
L.S.
Name
A senior officer of the Department for Social Development